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)
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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.
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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.
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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
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The Law: Ohio is one of the few states without a statewide Hospital Lien Statute.
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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.
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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”
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The Law: Ohio law mandates that hospitals provide free care to residents below the federal poverty line (HCAP).
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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.
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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.
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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.
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:
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HCAP Eligibility: Is this patient actually a charity case?
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SB 13 Deadlines: Is this debt about to expire under the 4-year rule?
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Cost: Included in service.
Phase 2: The “15-Day Notice” Protocol (Steps 1 & 2)
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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.
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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.
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The Cost: Flat fee (~$15/account). You keep 100% of recoveries.
Phase 3: Wage & Asset Leverage (Step 3)
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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?”
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The Cost: 40% contingency.
Phase 4: Litigation & Judgment (Step 4)
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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.
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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