Hospitals Earn Little From Suing For Unpaid Bills. For Patients, It Can Be 'Ruinous'

Olivia Falcigno/NPR
The Fredericksburg General District Court is a red-brick courthouse with Greek columns in a picturesque, Colonial Virginia town. A horse and carriage are usually parked outside the visitor center down the street.
On a sunny morning — the second Friday in June — the first defendant at court is a young woman, Daisha Smith, 24, who arrives early; she has just come off working an overnight shift at a group home for the elderly. She is here because the local hospital sued her for an unpaid medical bill — a bill she didn't know she owed until her wages started disappearing out of her paycheck.
The hospital, Mary Washington, sues so many patients that the court reserves a morning every month for its cases.
Inside the courthouse, it's not hard to figure out where to go. Right through court security, there are signs on colored paper: "If you are here for a MW case, please register at the civil window." When the elevators open, there's another Mary Washington sign. Wearing name badges, Mary Washington billing staff members walk through the halls. They've set up a kind of field office in a witness room at the back of the courtroom, where they are ready and waiting to set up payment plans for defendants.