Visited Er During Crisis While Covered By Both Private Insurance And The Va. Hospital Never Billed Insurance, Wrote It Off As Bad Debt Under Self Pay, And Sent It To Collections. Now The Hospital Won't Talk To Me.

I will keep it as simple as possible.

Location: Illinois; the hospital is in Nebraska.

Five years ago I visited the ER of a nonprofit hospital while in acute psychiatric crisis. I received care there and was transferred (the transfer hospital is not involved in this). While at the ER I informed them that I was enrolled with the Department of Veterans Affairs. I explicitly remember this, as the nurse made a joke about how she was supposed to call to transfer me to the VA by default, but she wasn't going to because they suck. I was also covered by private insurance at the time, Blue Cross/Blue Shield. It was also NOT my first visit to the hospital, and two previous ER visits had been paid out by Tricare. The hospital was very much aware I was affiliated with the VA.

Unfortunately due to the acute psychiatric crisis involved I cannot fully say what happened after as that ER visit was the beginning of a several year period where I was effectively homeless living with random people and mentally not remotely at capacity. I do not believe that I was notified about collections activity. I am at least certain I did not have any direct contact with the hospital regarding this appointment even though I had care with the hospital, this authorized and paid by the VA, at a later date between then and now.

That visit was in 2021/2022. I have gotten my life somewhat back on track, moved at least five times and to a different state, and been found permanently and totally disabled by the VA after the events following that hospitalization. I have no insurance. Two days ago I received a call from a debt collector informing me that they were attempting to collect for the encounter, a bill of several thousand dollars.

I contacted the hospital to ask why the charge had been sent to collections and not billed to the VA, and the billing clerk not only refused to discuss the matter as the bill was sent to collections, she informed me that there was no one else at the hospital who could help me when I asked if there was anyone who I could speak with about the billing issue, and I was told there was absolutely nothing that anyone could do at the hospital now that it was in collections. She was shockingly rude and didn't seem to be listening so I gave up. I received an itemized bill after the phone call that confirmed no payor was charged.

I contacted the debt collector; they had no additional information for me which I didn't expect them to, offered me a payment plan and a minimum amount I could pay instead to resolve the debt. I would do this and be done with it, but I rely only on my disability payment; it was granted based on inability to work. As is I'm in the kind of situation where I haven't bought groceries since the first of the month and there are no further corners to cut. I did not tell them that as it isn't their job to know much less care but that is the fact of the matter: I cannot pay this debt.

I contacted the VA. They investigated, and then told me it has been too long for them to pay out, even though it was the hospital's responsibility to have contacted them. They would have paid the bill in full if it was submitted appropriately, but it wasn't, and it now cannot be paid by the VA at all. The agent expressed to me that this exact scenario is incredibly common and told me to try to get the hospital to charge it off.

The minimum amount they offered me to pay is just above the amount where it can appear on a credit report even though it's medical debt and I also cannot afford this hit to my credit at this particular time as I'm preparing to apply for apartments.

I will freely eat crow. I have a lot of difficulty in managing my personal affairs for the exact reason I was in the hospital in the first place but only to the extent that I end up in situations like this, and not enough to receive any support. I am fully aware that I should have realized that the debt was unpaid sooner. Well, I did not.

I'm struggling quite a bit to understand how this even happened and why I'm responsible, much less if I have any legal recourse or if I need to go ahead and start selling stuff to pay it off. Do I?

Tl;dr:

- 2022: Nonprofit hospital processed a visit as self-pay during a period where I was covered by both BCBS and the DVA.

- 20?? I was unable to be contacted about the balance and the debt went to collections apparently all the way in 2026.

- The debt would have been paid by the VA. The hospital unequivocally made an error in not trying to bill them and I can't at all account for how they failed to bill BCBS.

- Regardless this is now my legal responsibility and I would simply pay it to make it go away, but I cannot afford to do so and need to know if I have any other recourse.