Debt Recovery

New Jersey Medical Collections: The “Louisa Carman” Act Has Rewritten the Rule

New Jersey is no longer a standard collection environment. With the enactment of the Louisa Carman Medical Debt Relief Act (July 2024), the state has implemented some of the strictest patient protections in the nation. If your current agency is still relying on credit reporting threats or aggressive wage garnishment, they are walking you into a compliance minefield.

For healthcare CFOs and Revenue Cycle Directors—from the large health systems in Hackensack to private practices in Cherry Hill—the “old way” of collecting is dead. You cannot simply demand payment; you must now navigate a complex flowchart of mandatory payment plans, income-based garnishment bans, and strict interest caps.

We don’t fight these new laws; we have re-engineered our recovery process to function within them, ensuring you get paid without triggering an Attorney General investigation.

Need a Medical Collection Agency in New Jersey? Contact us

Deep Analysis: The 3 New Barriers to Revenue in NJ

The Louisa Carman Act introduced three specific “revenue blockers” that most national agencies are not prepared for.

1. The “600% FPL” Garnishment Ban

The Law: Effective July 2025, New Jersey prohibits wage garnishment for medical debt if the patient’s income is below 600% of the Federal Poverty Level.
The Risk: This is not just for “low income” patients. For a family of four, 600% of the FPL is nearly $187,000. This effectively removes the threat of garnishment for the vast majority of your middle-class patients.
Our Solution: We shift focus away from wage garnishment (which is now often impossible) and towards asset execution (bank levies) and voluntary settlement negotiation based on psychological urgency rather than legal threats.

2. The “Credit Reporting” Blackout

The Law: Medical debt can no longer be reported to credit bureaus if it is under $500 (regardless of date) or for any services provided after July 22, 2024. Any reported debt that violates this becomes legally void.
The Risk: The traditional agency tactic of “wrecking their credit score” to force payment is now illegal in New Jersey.
Our Solution: We rely on direct contact frequencies and attorney-backed demand letters. Since we can’t hurt their credit score, we use the “nuisance factor” of consistent, compliant professional follow-up to drive payment.

3. The Mandatory 120-Day “Freeze”

The Law: You cannot engage in any collection actions until 120 days after the first bill is sent. During this time, you must offer a reasonable payment plan (max 3% interest).
The Risk: Sending an account to collections at “Day 90” (the industry standard) is now a violation of state law.
Our Solution: We have adjusted our intake API to automatically reject NJ files younger than 120 days, protecting you from accidental “early placement” liability.

Our 4-Step “Garden State” Recovery System

We have calibrated our model to clear the hurdles of N.J.S.A. 2A:44 (Liens) and the new Medical Debt Relief Act.

Phase 1: The “Charity Care” Scrub (Pre-Collection)

The Strategy: New Jersey regulations (N.J.A.C. 10:52-11.5) strictly mandate that hospitals screen patients for the Charity Care Program before billing.
The Action: We audit your files to ensure this screening is documented. If a patient claims hardship, we pause collection and help facilitate the Charity Care application. This often results in you getting paid by the State rather than chasing a broke patient.
Cost: Included in service.

Phase 2: The “Safe Harbor” Outreach (Steps 1 & 2)

The Strategy: Once the 120-day freeze lifts, we send the legally required “30-Day Pre-Collection Notice” which includes the mandatory statement that the debt will not be reported to credit bureaus.
The Psychology: We use this notice to offer a “Final Amnesty” payment plan that complies with the state’s new 3% interest cap.
The Cost: Flat fee (approx. $15/account). You keep 100% of recoveries.

Phase 3: The “Lien & Levy” Escalation (Step 3)

The Strategy: Since wage garnishment is restricted for many, we look for other liquidity.
For Accident Cases: We utilize N.J.S.A. 2A:44-41 to file hospital liens with the county clerk. These liens attach specifically to personal injury settlements, ensuring you get paid before the patient receives their check.
The Cost: 40% contingency.

Phase 4: Strategic Litigation (Step 4)

The Strategy: For high-income debtors (above the 600% threshold) or those with significant assets, we file suit in the Superior Court of New Jersey. We target bank accounts and property liens, which are often more effective than wage garnishment in NJ anyway.
The Cost: 50% contingency.

Nexa provides 100% reputation-safe, equipped with all 50-state collections license, offering free credit reporting, free litigation, free bankruptcy scrubs, and zero onboarding fees. Secure – SOC 2 Type II & HIPAA compliant. Over 2,000 online reviews rate us 4.85 out of 5.

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Regional Strategy: One State, Two Markets

We adjust our approach based on the patient’s economic zone.

Region	Economic Profile	Collection Strategy
North Jersey (Bergen/Hudson)	High Income / Commuter	High usage of payment plans. We structure plans to fit the “3% interest” rule, making them attractive alternatives to ignoring the bill.
South Jersey (Camden/Gloucester)	Philly Metro / Mixed	Heavy focus on Insurance Cleanup. Many patients here cross state lines for care; we are experts at resolving “Out of Network” disputes with PA-based insurers (like Independence Blue Cross).
The Shore (Monmouth/Ocean)	Seasonal / Retail	We time our calls to align with seasonal cash flow for business owners and service workers.

FAQ: The Executive Summary

Q: Can we charge interest on medical debt in NJ?

A: Yes, but it is capped strictly at 3% per year under the Louisa Carman Act. Charging the old standard of 6-10% is now illegal. We automate this calculation to ensure you never commit usury.

Q: What is the Statute of Limitations?

A: You generally have 6 years to file a lawsuit for unpaid medical bills in New Jersey. However, because you must wait 120 days to start, your effective window is slightly shorter. Speed is critical once that window opens.

Q: How do we handle accident cases (MVA)?

A: New Jersey private hospitals must file a Notice of Lien with the county clerk to secure rights to a settlement. Unlike some states, this must be done meticulously to prevent the “release of claim” by the patient. We handle this filing for you.

Click here for a Free “Louisa Carman Act” Compliance Audit

Michigan Medical Collections: The “One-Year Back” Rule & The No-Fault Trap

Given Michigan’s unique intersection of “No-Fault” auto insurance laws and rigid garnishment reporting rules, it is crucial to partner with a specialist who understands the local Public Health Code. Attempting do-it-yourself collection here doesn’t just risk lower recovery—it risks permanently extinguishing your right to payment under the strict “One-Year Back” rule.

For revenue cycle directors in Michigan—whether you are with a major system like Henry Ford Health or a private practice in Grand Rapids—collecting medical debt requires navigating one of the most complex insurance environments in the country.

If your agency treats a “PIP Claim” the same way they treat a standard “Health Insurance” balance, they aren’t just failing to collect—they are actively letting your legal claim expire. We act as a specialized revenue firewall, protecting you from the administrative traps hidden in Michigan’s statutes.

Need a Medical Collection Agency? Contact us

Deep Analysis: The Three “Revenue Leaks” in Michigan

Collecting in the Great Lakes State requires a strategy that accounts for specific legislative pitfalls. Here is why standard national agencies fail here:

1. The “One-Year Back” Rule (No-Fault Auto)

The Law: Under Michigan’s No-Fault Act (MCL 500.3145), you generally have only one year from the date of service to file a lawsuit against an auto insurer for unpaid medical bills.
The Risk: Many agencies treat auto-accident accounts like standard bad debt, letting them sit in a queue for months. If they wait 12 months and 1 day, your claim is extinguished forever. You cannot sue the insurer, and strict balance-billing rules often prevent you from billing the patient.
Our Solution: We flag all “MVA” (Motor Vehicle Accident) accounts upon intake. If the Date of Service is approaching the 10-month mark, we expedite the file to our legal team to preserve your rights before the statute expires.

2. The “6-Month Garnishment” Disclosure

The Law: Michigan allows wage garnishment until the debt is paid (unlike states where it expires quickly). However, there is a catch: The creditor must provide a statement of the remaining balance to the employer and defendant every 6 months.
The Risk: “Set it and forget it” agencies often fail to send these mandatory updates. This creates a valid defense for the debtor to have the garnishment dismissed and can even compel you to return collected funds.
Our Solution: Our system automatically generates and mails these 6-month statutory updates, ensuring your revenue stream doesn’t dry up due to a clerical error.

3. The Strict “100-Day” Lien Limit

The Law: Michigan’s Hospital Lien Act is much tighter than other states. You can only place a lien on a patient’s tort settlement for the first 100 days of treatment (following the accident).
The Risk: Filing a lien for treatment provided on “Day 101” is legally invalid and can expose your facility to “slander of title” counter-suits.
Our Solution: We audit your itemized bills before filing any liens. We separate “Lien-Eligible” charges from “Standard Collections” to ensure every legal filing is bulletproof.

Our 4-Step “Great Lakes” Recovery System

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We have calibrated our recovery model to fit Michigan’s 6-year statute of limitations for contracts and its specific consumer protections.

Phase 1: The No-Fault Triage (Pre-Collection)

Before we demand payment from a patient, we check the “Financial Class” of the debt.

Is this an Auto Accident? If yes, we verify if the “One-Year Back” clock is ticking. We don’t harass the patient for a bill that Allstate or State Farm should have paid.
Cost: Included in service.

Phase 2: The “Statutory Nudge” (Steps 1 & 2)

The Strategy: We send a series of firm, compliant demands. We reference Michigan’s 6-year Statute of Limitations, reminding debtors that this debt will not simply “go away” quickly (unlike in states with shorter windows like PA or DE).
The Cost: A simple flat fee (approx. $15/account).
The Benefit: You clear out the low-hanging fruit—patients who simply forgot to pay—without paying a commission. You keep 100% of these recoveries.

Phase 3: The Wage Lever (Step 3)

The Strategy: If the patient ignores us, we escalate. Michigan law allows garnishment of up to 25% of disposable earnings.
The Negotiation: We use this as leverage. “Mr. Jones, a court order could take 25% of your paycheck. Let’s set up a voluntary plan for 10% instead.” This logic works.
The Cost: 40% contingency.

Phase 4: Litigation & Maintenance (Step 4)

The Strategy: For high-balance accounts, we file suit in the local District Court. Once we get the judgment, we manage the periodic garnishment process, including the mandatory 6-month balance statements, so you don’t have to track them.
The Cost: 50% contingency.

Regional Strategy: From Detroit to the U.P.

Michigan is economically diverse. We adjust our tactics based on the patient’s location.

Region	Economic Profile	Collection Strategy
Southeast (Detroit/Wayne Co.)	High Auto Insurance Volume	Heavy focus on “No-Fault” coordination and PIP claim verification.
West MI (Grand Rapids)	Medical Manufacturing/Service	Focus on employer benefit verification; higher success with voluntary payment plans.
Northern MI / U.P.	Rural/Tourism	We utilize “seasonality” in our calls, knowing cash flow is tighter in winter months for tourism workers.

FAQ: The Executive Summary

Q: Can you collect on a debt that is 5 years old?

A: Yes. Michigan has a 6-year Statute of Limitations for contract disputes (which covers most medical debt). However, collecting on a 5-year-old debt is difficult. We recommend listing accounts at 90-120 days past due for maximum recovery.

Q: What if the patient claims they have “No-Fault” insurance?

A: We stop and verify immediately. If they were in an accident, their auto insurance is likely the primary payer. We request the claim number and adjuster info to file before the 1-year deadline hits.

Q: Do you report to credit bureaus?

A: We can, but with caution. With state-level discussions (Senate Bill 451) proposing to ban medical debt reporting in Michigan, we are shifting our focus to direct contact and legal recovery rather than relying on credit damage.

Click here for a Free Compliance Audit of Your Michigan Claims

Debt Collection for Music Stores: Professional Recovery for Instrument Rentals & Repairs

Orchestrating Financial Harmony: Recovery for the Local Music Scene

Your store provides the soundtrack to our community, from the first screechy violin lesson to the local jazz trio’s Friday night set. We understand that when a high-end saxophone rental goes missing or a vintage amplifier repair bill goes unpaid, it’s not just a line item—it’s a disruption of your rhythm. Our Account Reconciliation Team ensures that your shop stays in tune while we handle the difficult conversations with the “Velvet Hammer” touch.

Nexa provides a reputation-safe approach, equipped with all 50-state collections license, offering free credit reporting, free litigation, free bankruptcy scrubs, and zero onboarding fees. Secure – SOC 2 Type II compliant. Over 2,000 online reviews rate us 4.85 out of 5. We are serving over 50 music stores nationwide.

Need a Collection Agency? Contact us

Pricing Designed for Every Octave

We believe in transparent recovery that scales with your needs. Whether you are dealing with a bulk of small lesson fees or a single high-value instrument rental, our current rates remain consistent:

Fixed-Fee Option: Only $15 per account. You retain 100% of the recovered funds. This is ideal for early-stage delinquency where a firm, professional nudge is all that’s required.
Contingency Option: 40% fee—if we don’t recover your money, you don’t pay a cent.
Equipment Recovery Discount: We recognize that a returned instrument may have suffered wear and tear. If the customer returns the merchandise rather than paying the full balance, our contingency fee drops to 25% to account for the depreciation of the equipment.

Money Saver Tip: Most of our partners effectively receive our fixed-fee service for free. By consulting your CPA, you can often declare these costs as a necessary Business Expense on your current tax filings, neutralizing the overhead.

🚩 Local Pitfalls: 3 Red Flags for Music Retailers

The “Grace Period” Trap: Waiting until the end of a semester to chase unreturned school rentals often leads to “skip” situations where families move without notice.
The Handshake Repair: Performing high-value repairs without a signed “authorization to work” that includes collection cost clauses makes recovery harder.
Employee Outreach: Asking your master luthier or floor manager to make collection calls wastes their talent and often results in awkward, ineffective confrontations that damage your shop’s reputation.

A Note from the Account Reconciliation Team

We view ourselves as an extension of your front office. Our goal isn’t just to “get the money”—it’s to resolve the friction that stops a customer from coming back. We use empathetic, bilingual communication (Spanish and English) to navigate these sensitive waters. By the time an account reaches us, we know the “will to pay” is often buried under life’s distractions. We dig it back out without the noise.

Why Cooperative Mediation Wins: The Velvet Hammer

We recover more because we work with the debtor, not against them. Our “Velvet Hammer” approach is firm enough to secure a commitment but soft enough to protect your 5-star online reputation. By treating the customer with respect, we move your bill to the top of their priority list.

Before we ever dial a number, we perform a litigation scrub to ensure we aren’t chasing “judgment-proof” individuals or those with a history of litigious behavior. This protects you from risk and keeps our recovery rates significantly higher than the industry average. When appropriate, we leverage text and email to speed up responses, meeting customers on the platforms they actually use.

Recent Success Stories

Case 1: The “Vanished” Cello Rental
A customer stopped payments on a professional-grade cello and ceased all communication.

Step 1: We performed a skip trace and USPS address check, locating the debtor in a neighboring county.
Step 2: Our Spanish-speaking collector reached out, discovering a family medical emergency had caused the lapse.
Result: The cello was returned within 48 hours, and a settlement for the past-due rental fees was reached, billed at the 25% equipment recovery rate.

Case 2: The Studio Repair Bill
A local recording studio owner owed a significant balance for a console repair but was disputing the final labor hours.

Step 1: We acted as a neutral third party to review the invoice and the studio’s concerns.
Step 2: Using diplomatic mediation, we negotiated a three-part payment plan that secured the full balance without litigation.
Result: 100% recovery achieved within 30 days.

Compliance and Modern Logistics

We navigate the complexities of federal rules, including the Fair Debt Collection Practices Act (FDCPA), to ensure your business is never at legal risk. Our process includes:

Skip Tracing & USPS Checks: Finding customers who have moved.
Bankruptcy & Litigation Scrubs: Identifying risk before we engage.
Credit Reporting: Available where permitted and chosen by you.
Quality Control: All calls are recorded and randomly reviewed to prevent “rogue collector” behavior and protect you from review-bombing.

Frequently Asked Questions

Does involving an agency mean I’ll lose the customer forever?

Actually, the opposite is often true. By using our “Velvet Hammer” approach, we resolve the “shame” of the debt, which often allows the customer to return to your shop once they are square.

Why should I assign accounts early?

Data shows that the earlier an account is assigned to a professional team, the higher the recovery rate. Waiting makes the trail go cold.

How do you handle customers who only speak Spanish?

We have dedicated bilingual collectors on board. This ensures no meaning is lost in translation and every customer is treated with professional clarity.

Is there a specific local rule for music rentals in our area?

While federal law governs the basics, we ensure all address checks and skip tracing follow current local statutes to maintain a “reputation-safe” recovery process.

Secure Your Revenue – Contact Nexa Today

Collection Agency for Plastic Surgeons: Recover Unpaid Bill

Nearly 2 million Americans undergo plastic surgery every year. Unfortunately, thousands of these patients default on their payment obligations, and many of these receivables are eventually forwarded to a Collection Agency.

Since cosmetic surgery is considered an elective surgery, it is usually not covered by regular insurance. Even though most patients use their Cash Savings, Health Cards ( like Care Credit Card), PatientFi, and Personal Credit Cards to make payments, many patients make payment arrangements directly with the doctor’s office. These arrangements can vary in detail and scope.

Most popular plastic surgery procedures include: Breast augmentation, Liposuction, Eyelid surgery, Nose surgery, Tummy Tuck and Tumor removal. It is estimated that Americans spend over 16 billion dollars annually on cosmetic and plastic surgeries. Since the cost of these procedures run from $3,000 to upwards of $25,000, non-payment by just a few patients can have a huge impact on the cash flow and profitability of the doctor’s office.

The in-house staff at the plastic surgeon’s office is really not qualified or experienced to handle past-due bills beyond sending a few reminder letters and making phone calls. This is where a Debt Collection Agency comes in and attempts to recover the unpaid bill more persistently, diplomatically and (most important) legally. Collection agencies have tools and subscriptions to various services that assist in a successful recovery of the medical bill. They can even initiate legal action against the patient by taking him to court if nothing else works.

The moment a Collection Agency is involved, the whole equation changes. Frankly, no one wants to hear from a Collection Agency.

The patient knows that the case has been forwarded to a professional debt collector and all those excuses he has been giving to the plastic surgeon’s office so far will not work anymore. They will now have to face all possible recovery measures permissible under the law.

The fees charged by collection agencies are worth the investment. In-fact if a plastic surgeon wishes, the case can be directly assigned for contingency collections in which there are no fees unless a recovery is made.

A plastic surgeon should hire a collection agency carefully. It is important to know whether the agency has extensive experience with medical collections and if it is insured. Do not go for a collection agency simply because it is near you, go for the better one instead. Your collection agency should be licensed to collect in the state where your debtors are located.

Just a handful of collection agencies perform the Litigious Patient scrub to check if the patient has a history of filing lawsuits ( or frivolous lawsuits), in such cases, the collection agency will advise the doctor’s office to take an alternate approach just to be safe.

If you need a debt collection agency with extensive experience in medical collections: Contact Us

Collision Repair Debt: Recovering “Pocketed Checks” & Deficiency Balances

In the auto body industry, you aren’t just fighting rust and bent frames; you are fighting a payment system designed to fail you.

The most dangerous phrase in a shop owner’s life is: “The insurance company said they mailed the check to me, I’ll bring it in when it arrives.“

When that customer ghosts you, it isn’t just a late payment. In many jurisdictions, spending an insurance payout designated for repairs is a form of insurance fraud or theft by conversion. You need a collection partner who knows how to use that leverage.

Need a Collection Agency for your Automotive Workshop: Contact Us

The 3 Hidden Revenue Leaks in Body Shops

1. The “Direction to Pay” Violation

You had the customer sign a Direction to Pay. The insurer ignored it (or claimed “clerical error”) and mailed a $4,500 check to the vehicle owner. The owner cashed it and stopped answering your calls.

The Agency Fix: This requires a specialized “misappropriation of funds” demand. A standard “please pay us” letter is weak here. The debtor needs to understand that this is bordering on criminal liability.

2. The “Lien Sale” Deficiency

You have a car that has been racking up storage fees for 60 days. The bill is $8,000. The car is a totaled 2014 sedan worth only $2,000 at auction.

The Trap: Most shops think, “I’ll just do a lien sale.”
The Reality: The lien sale gets you $2,000. You are still out $6,000. This is called a Deficiency Balance.
The Solution: You can (and should) send that remaining $6,000 balance to collections. The lien sale does not wipe the debt clean; it only offsets it.

3. “Project Purgatory” (Restoration Stalls)

Restoration shops face a unique nightmare: The “open checkbook” client who suddenly snaps the wallet shut when the car is stripped to the frame.

The Risk: You have a bay occupied by a non-rolling chassis. You can’t put a lien on a pile of parts easily, and you can’t push it outside to rust.
The Fix: Aggressive contract enforcement to recover “lost bay time” and labor hours already sunk into the tear-down.

Recent Results: Real Recovery Scenarios

These are actual types of cases specialized automotive agencies are resolving in 2025.

Case Study #1: The ADAS Calibration Dispute
- The Debt: $1,450.
- The Story: A customer picked up their vehicle but refused to pay for the “Post-Scan” and “Radar Calibration,” claiming it was a “money grab” that the insurance adjuster initially hesitated to approve.
- The Outcome: The agency utilized the OEM Repair Procedures documentation to prove the safety necessity of the charge. The customer paid in full once the agency clarified the liability of driving an uncalibrated vehicle.
Case Study #2: The “Pocketed” Supplement
- The Debt: $4,200.
- The Story: Shop released a truck after the primary repair. A hidden damage supplement was approved later. The insurer sent the supplement check to the vehicle owner, who used it to pay their mortgage.
- The Outcome: The collection team treated this as a wrongful retention of funds. Facing a potential credit score collapse and legal escalation regarding the misappropriated funds, the debtor arranged a 3-month repayment plan.

Frequently Asked Questions

Q: Can a collection agency help if I didn’t get a signature on the final invoice?

A: It is harder, but yes. If you have the pre-authorization to repair and text messages/emails approving the work or acknowledging the completion, that is often enough evidence to validate the debt. Digital footprints count.

Q: Does sending a customer to collections void the warranty on their repair?

A: Generally, yes. Most standard repair contracts state that warranties are only valid on “paid in full” invoices. A collection agency can use this as leverage: “Mr. Smith, your lifetime paint warranty is void until this $500 deductible is settled.”

Q: I charged storage fees because they left the car for 3 weeks after it was ready. Can I collect that?

A: Only if your initial intake paperwork clearly lists your daily storage rate and the “grace period” (e.g., Storage charges of $75/day begin 48 hours after notice of completion). If this was posted clearly, it is a valid, collectible debt.

Stop acting as a free bank for your customers.

If you need a cost-effective Collection Agency to help you recover past-due bills: Contact Us

Ohio Medical Debt Recovery: The “Compliance Minefield” Hidden Behind Creditor-Friendly Laws

Given Ohio’s strict medical debt collection regulations, it is crucial to hire a specialist well-versed in state laws. Attempting do-it-yourself collection carries a high risk of legal non-compliance and potential litigation.

On the surface, Ohio looks like a paradise for debt collection. But this “easy” environment is deceptive.

Ohio presents a unique set of traps—specifically Senate Bill 13, the HCAP (Hospital Care Assurance Program) mandate, and the lack of a statutory hospital lien law—that often result in uncollected revenue or, worse, class-action liability for healthcare providers.

Our agency doesn’t just “call and collect.” We analyze your portfolio against Ohio’s specific legal framework to close the loopholes where revenue leaks out.

Deep Analysis: The Three “Silent Killers” of Ohio Medical Revenue

Most agencies treat Ohio like any other state. That is a mistake. Here is the strategic analysis of why standard collection methods fail here:

1. The “Intake Form” Vulnerability (SB 13 Impact)

The Law: Ohio recently slashed its Statute of Limitations. It is no longer 15 years. It is now 6 years for written contracts and 4 years for oral contracts/accounts.
The Risk: Many providers have intake forms that don’t legally qualify as a “written contract” under the new strict standards of SB 13. If your registration paperwork is flimsy, your collection window shrinks by two full years.
Our Solution: We audit your “Date of Service” vs. “Intake Documentation.” If we identify accounts approaching the 4-year mark, we accelerate them immediately to Step 3 or 4 before they become time-barred.

2. The “Lien Void” in Personal Injury Cases

The Law: Ohio is one of the few states without a statewide Hospital Lien Statute.
The Risk: If your patient is in a car accident and expects a settlement, you cannot simply “file a lien” with the county clerk to guarantee you get paid from the insurance check. If you wait for the case to settle, the patient often takes the money and disappears.
Our Solution: We aggressively pursue Letters of Protection (LOP) and Assignments of Benefits signed by both the patient and their personal injury attorney. We create a contractual lien where the statutory one is missing.

3. The HCAP “Compliance Trap”

The Law: Ohio law mandates that hospitals provide free care to residents below the federal poverty line (HCAP).
The Risk: If you send an account to collections without properly screening for HCAP eligibility, you are violating state regulations. Aggressive agencies that skip this step put your hospital’s tax-exempt status and state funding at risk.
Our Solution: We integrate a “Poverty Screen” into our Step 1 process. If a debtor claims hardship, we don’t just yell louder; we verify if they qualify for HCAP retroactive coverage, potentially getting you paid via state funds rather than the patient.

Future-Proofing: Preparing for HB 257

Current legislative session (2025)

The Ohio Medical Debt Fairness Act (HB 257) is currently moving through the legislature. It threatens to cap interest rates at 3% and ban medical debt reporting.

Our Strategy: We are shifting away from “credit reporting” as a primary leverage tool. Instead, we are focusing on legal execution (garnishment) and asset verification, ensuring that even if the laws change, your recovery percentages don’t drop.

Need a Collection Agency? Contact us

Our 4-Step “Buckeye” Recovery System

We have adapted our standard model to leverage Ohio’s creditor tools while navigating its compliance traps.

Phase 1: The Audit & Scrub (Pre-Collection)

Before the clock starts, we scrub your files against:

HCAP Eligibility: Is this patient actually a charity case?
SB 13 Deadlines: Is this debt about to expire under the 4-year rule?

Cost: Included in service.

Phase 2: The “15-Day Notice” Protocol (Steps 1 & 2)

The Strategy: We send the legally required “Notice of Court Proceeding to Collect Debt” (often called the 15-day letter) early in the process. This is the prerequisite for garnishment.
The Psychology: When a patient sees a formal legal notice referencing their specific employer and the threat of wage attachment, priority shifts immediately to your bill.
The Cost: Flat fee (~$15/account). You keep 100% of recoveries.

Phase 3: Wage & Asset Leverage (Step 3)

The Strategy: Unlike PA, we can pursue 25% of disposable earnings. We negotiate payment plans based on this hard number. “Mr. Smith, we can set up a $200/month plan voluntarily, or the court order will take $450/month from your paycheck. Which do you prefer?”
The Cost: 40% contingency.

Phase 4: Litigation & Judgment (Step 4)

The Strategy: We use Ohio’s efficient Municipal Court system to obtain judgments. Once we have a judgment, we can execute bank attachments or garnishments.
The Cost: 50% contingency.

Regional Strategy: One State, Three Economies

Collecting in Ohio requires knowing the local economic pulse.

Region	Economic Profile	Collection Strategy
Northeast (Cleveland/Akron)	Heavy Healthcare/Industrial	High awareness of HCAP; we focus on insurance cleanup and union benefit coordination.
Central (Columbus)	Service/Tech/Gov	Higher transience. We use heavy skip-tracing to find young professionals who move frequently.
Appalachia (SE Ohio)	Rural/Low-Income	High HCAP volume. We focus on respectful, long-term payment plans ($50/month) that patients can actually sustain.

FAQ: The Executive Summary

Q: My current agency says they “file liens” on auto accidents. Are they lying?

A: They are likely using a generic UCC filing or bluffing. Without a specific Ohio Hospital Lien Statute, those “liens” are often legally weak. We use direct attorney contracts (Letters of Protection) which are far more enforceable in Ohio courts.

Q: What happens if the patient moves to Pennsylvania?

A: This is a common issue in Eastern Ohio. If they move to PA, we lose the ability to garnish wages (due to PA law). We rush to secure a judgment in Ohio before they move, or we transfer the file to our PA-specific team to use asset-levy strategies instead.

Q: Can we charge interest on old medical debt?

A: Yes, but be careful. The statutory rate changes annually (typically Federal short-term rate + 3%). For 2025, it is approx 8%. Charging more than the statutory limit can trigger a usury lawsuit. We automate this calculation to ensure strict compliance.

Stop using a “one-size-fits-all” strategy in a state with complex liability traps.

Click here for a Free Compliance Audit of Your Ohio Bad Debt