Medical Grievance Letter

By | June 13, 2012

(Your Address Line 1)

(Your Address Line 2)

(Date)

Billing Collection Department

(Name of Hospital)

(Hospital Address Line 1)

(Hospital Address Line 2)


To whom it may concern:

I was confined at your hospital from (date) to (date). Prior to my discharge, I have settled all my hospital bills with you through my health insurance coverage. It was to my surprise then that on (date) I received a notice from (Name of Collection Agency) demanding payment of $ (amount).

I am enclosing the proof of payment sent by my health insurance agency for you to reconcile your records. I am demanding immediate attention to this matter since it has greatly damaged my credit rating.

Please notify me immediately by mail on the action taken regarding this matter. If I hear nothing from you within ten (10) days from receipt of this letter, I will be compelled to take all necessary legal actions against your hospital.

Sincerely,

(Your Signature)

(Your Name in Print)


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