Fighting Medical Debt in Tennessee

I got a medical bill I can't afford — here's what Tennessee law says and what to do next.

Tennessee Law

Statute: Tenn. Code § 56-7-1201 et seq. (Tennessee Balance Billing Protections)

Deadline: 120 days

Penalty: Tennessee restricts balance billing for emergency services. Violations may result in penalties from the Tennessee Department of Commerce and Insurance

What is fighting medical debt?

Medical debt is the leading cause of bankruptcy in the United States, affecting an estimated 100 million Americans. Recent federal actions have significantly strengthened your rights when dealing with medical debt — including new rules removing most medical debt from credit reports and protections against surprise billing.

The No Surprises Act (effective January 2022) protects you from unexpected bills when you receive emergency care or are treated by an out-of-network provider at an in-network facility without your consent. Additionally, the three major credit bureaus voluntarily removed medical debt under $500 from credit reports in 2023, and the CFPB finalized a rule in January 2025 to remove all medical debt from credit reports, but a federal court vacated that rule in July 2025 (Cornerstone Credit Union League v. CFPB) before it took effect.

What to Do If You Get a Medical Bill You Can't Afford

Step 1: Request an itemized bill. Medical billing errors are extremely common — studies suggest up to 80% of medical bills contain errors. Compare the itemized bill against your insurance Explanation of Benefits (EOB).

Step 2: If you received a surprise bill (out-of-network charges you didn't consent to), file a complaint under the No Surprises Act. Contact your insurer, the provider, and CMS at 1-800-985-3059. You should only owe your in-network cost-sharing amount.

Step 3: Ask the hospital about financial assistance. If the hospital is a nonprofit (most are), they must have a financial assistance policy. Request the application — you may qualify for free or reduced-cost care even with insurance.

Step 4: Negotiate the bill. Hospitals regularly accept less than the full amount. Ask for a reduction, a payment plan with no interest, or offer a lump-sum settlement for a lower amount. Get any agreement in writing.

Step 5: If the debt goes to collections, know your FDCPA rights. Request debt validation in writing within 30 days. Medical debt collectors must follow the same rules as any other debt collector. If the debt is on your credit report, check whether it qualifies for removal under the new credit reporting rules.

How Tennessee differs from federal law

Tennessee provides some protections for residents dealing with medical debt:

  • No wage garnishment for most debts: Tennessee is one of the few states that does not allow wage garnishment for most consumer debts, including medical debt — only taxes, child support, and student loans can be garnished from wages
  • Statute of limitations: The statute of limitations on written contracts (including medical debt) in Tennessee is 6 years (TCA § 28-3-109). After this period, creditors cannot sue to collect
  • Hospital lien law (TCA § 29-22-101): Hospitals can place liens on personal injury settlements for unpaid medical bills, but there are notice requirements and limitations
  • TennCare (Medicaid): Tennessee's Medicaid program covers adults with very limited eligibility (no ACA expansion), leaving many low-income residents at risk of medical debt
  • Non-profit hospital obligations: Non-profit hospitals must have financial assistance policies. Tennessee law requires hospitals to provide discounts to uninsured and underinsured patients

Additional steps in Tennessee

Request an itemized bill and check for errors. Ask the hospital about financial assistance programs and charity care. File debt collection complaints with the Tennessee Division of Consumer Affairs at (615) 741-4737. Contact Legal Aid Society of Middle Tennessee at (615) 244-6610 for free legal help.

What you should NOT do

Don't pay a bill you haven't verified. Always request an itemized bill and compare it to your insurance EOB before paying. Errors are extremely common.

Don't put medical debt on a credit card. Medical debt has special protections (lower interest, financial assistance eligibility, credit reporting limits) that you lose once you transfer it to a credit card.

Don't ignore the bill entirely. While medical debt protections are expanding, ignoring bills can lead to lawsuits, wage garnishment, and damage to your credit that could have been avoided through negotiation or financial assistance.

Don't assume you don't qualify for financial assistance. Income thresholds for hospital charity care programs are often surprisingly high (200-400% of the federal poverty level). Apply even if you think your income is too high.

You shouldn't have to hire a lawyer to assert your rights.

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This page is general legal information for Tennessee, not legal advice for your specific situation. Laws change, and how a statute applies depends on facts we don't know. For advice on your matter, consult a licensed attorney in Tennessee.

You came here to know your rights — help someone else know theirs.

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