Medical debt collection agencies in Texas

State registers re-read every week · latest read: October 8, 2026

Sources: agency websites and the Texas Secretary of State TPDC Public Search Portal.

What is medical debt collection?

Medical debt is the patient-owed remainder of a healthcare bill: deductibles, copays, out-of-network balances and self-pay accounts left after insurance has finished paying, or never applied at all. Hospitals, physician groups, labs and billing companies typically work accounts internally or through an early-out program first, then place what remains with a collection agency, and healthcare is the one vertical where many agencies build their entire identity around the work: more agencies in this directory declare it as their specialty than any other category.

It is also the most sensitive corner of collections. The debtor is a patient, the account trail includes protected health information, and the provider's reputation rides on every call, which is why the specialist agencies below sell their patient-experience approach as hard as their recovery rates.

The rules that govern medical debt collection in Texas

Texas added a rule in 2023 that anyone placing medical accounts must know. Health and Safety Code Chapter 185 requires a provider to give the patient a written, itemized bill, in plain language, within 30 days of receiving final payment from a third party, and its Section 185.002(e) is blunt: "A health care provider may not pursue debt collection against a patient for a provided health care service or supply unless the provider has complied with this section." The chapter even defines "debt collection" by reference to Finance Code Chapter 392, the same statute behind the rest of Texas collection law, and a licensing authority can discipline a provider that violates it (Section 185.003). For bills issued since September 1, 2025 (House Bill 216, adding Section 185.002(c-1), read October 5, 2026), a provider that issues the bill through a patient portal must check, if feasible, whether the patient has an active portal profile, and must mail, email or hand over a copy by the patient's chosen method when the patient has none or the provider cannot tell. Practical consequence: accounts placed without the itemized-bill step are not lawfully collectable, so both providers and their agencies need proof of compliance in the file. One limit on its reach: the chapter's definition of a health care provider excludes a federally qualified health center.

The general layer applies on top: Chapter 392's conduct rules and the federal FDCPA and Regulation F (covered in how collection agencies work), and the limitations period (four years for most debts, with the exceptions set out on the Texas debt law page). One honest omission: the CFPB's 2025 rule on medical debt and credit reporting was vacated by the U.S. District Court for the Eastern District of Texas on July 11, 2025, so this page cites no federal rule from that area.

What to ask an agency before placing medical debt

• How the agency verifies Chapter 185 compliance before working an account: what proof of the itemized bill it requires from you at placement.
• How protected health information is handled: whether it signs a business associate agreement and who may access patient records.
• What its patient-experience approach actually is: scripts, complaint handling, and how disputes trigger a pause and an insurance re-check rather than pressure.
• Whether it can re-bill or coordinate with insurers on disputed balances, or only collect.

Medical and healthcare collection specialists (55 agencies)

Agencies whose own websites present medical and healthcare collections as their identity.

Grouped by track record band, alphabetical within each band. No ordinal ranking. A quoted claim links to the page on the agency's own website where it appears, with the date we read it; a row without a quote is a declaration we have not yet captured.

Also serve medical and healthcare collections, among other industries (73 agencies)

Agencies whose websites list medical and healthcare collections within a broader industry menu. Serving an industry is not the same claim as specializing in it.

How this ranking works

Agencies are grouped into bands by how many years they have been continuously bonded on the Texas Secretary of State's public register: 25 or more years, then 15-24, 5-14, and under 5. Within a band, agencies are listed alphabetically, so no agency is ranked above another and there are no ordinal positions. Only agencies whose bond is active on the register appear in a band. A long bond history is a verifiable public record of staying in business under the state's one legal requirement; it is not a quality rating. Rankings are never for sale: paid options are clearly labeled and can never change where an agency sits. The full rules are on the methodology page.

Common questions about medical debt collection in Texas

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