Medical Grievance Letter

By | June 13, 2012

(Your Address Line 1)

(Your Address Line 2)


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.


(Your Signature)

(Your Name in Print)

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