Americans received an estimated 3.2 billion debt collection calls in 2024, and medical debt drove more CFPB complaints than any other debt category. BillKarma's survey of 1,200 users dealing with medical collections found that 47% reported receiving calls they considered harassing — multiple calls per day, calls at night, or calls to family members. The law is on your side. Here is exactly how to make the calls stop.
1. Your rights: when and how collectors can contact you
The Fair Debt Collection Practices Act (FDCPA) and the CFPB's Regulation F set clear boundaries on how medical debt collectors can contact you. These are not suggestions — they are federal law.
| Rule | What it means | Violation example |
|---|---|---|
| No calls before 8 a.m. or after 9 p.m. | Your local time zone applies | Call at 9:15 p.m. from a different time zone |
| 7 call attempts per 7 days per debt | Includes unanswered calls and voicemails | Calling 3 times in one day, 12 times in a week |
| No calls within 7 days of a conversation | Once you speak with them, 7-day cooldown starts | Calling the next day after you already spoke |
| No workplace calls after you object | One verbal or written request stops workplace calls | Calling your office after you said "don't call here" |
| No third-party disclosure | Cannot tell family, friends, or coworkers about your debt | Telling your spouse "your husband owes us $4,000" |
| No harassment, threats, or profanity | Covers tone, language, and content of calls | "We'll have you arrested" or repeated profanity |
Text messages and emails are also covered by Regulation F. Collectors who contact you electronically must include an opt-out method in every message and cannot send more than the same frequency limits. Social media direct messages are allowed only if you can control who sees them (private messages only).
2. Call limits under federal law
The CFPB's 2021 Regulation F established the first specific numerical limits on collector calls:
| Limit | Details |
|---|---|
| 7 calls per 7 days per debt | This counts attempts, not just connected calls. Voicemails count. If you have 3 medical debts with the same collector, they can attempt 7 calls per debt (21 total) — but many consumers don't realize this multiplier effect. |
| 7-day post-conversation cooling period | After you actually speak with the collector about a specific debt, they cannot call about that debt for 7 days. |
| No "continuous or repeated" calling | Even within the 7-call limit, calling with the intent to harass (e.g., calling 7 times in one hour) is still an FDCPA violation. |
According to BillKarma data, the average medical debt collection account generates 4.3 call attempts per week. That is within the legal limit, but many users report feeling overwhelmed — especially when multiple debts from a single hospital visit are treated as separate accounts, each with its own 7-call allowance.
3. How to send a cease-and-desist letter
A cease-and-desist letter is the legally binding way to stop collector calls. Under FDCPA § 1692c(c), once a collector receives a written request to stop communication, they can only contact you to:
- Confirm they are ceasing communication
- Notify you of a specific legal action (like filing a lawsuit)
They cannot call, text, email, or send collection letters after receiving your cease-and-desist.
What your cease-and-desist letter should include
Important considerations before sending:
- Send a debt validation letter first. If you are within the 30-day validation window, send a debt validation letter before or alongside the cease-and-desist. The validation letter forces the collector to prove the debt — the cease-and-desist just stops communication.
- A cease-and-desist does not eliminate the debt. The collector can still sue you (and must be allowed to notify you of that). It only stops the phone calls, letters, and emails.
- Use certified mail with return receipt. This creates legal proof of delivery.
Want to send both a validation and cease-and-desist letter? Our letter generator creates both documents and handles certified mailing through USPS.
4. Documenting harassment
If a collector has been harassing you, documentation is your ammunition for complaints and potential lawsuits. Here is what to collect:
Phone calls
- Screenshot your call log showing the collector's number, timestamps, and frequency
- Save all voicemails — many phones allow you to share voicemail recordings as audio files
- Note every call in a simple log: date, time, caller's name (ask for it), what was said, and whether you were at work or at home
- Record calls if legal in your state — 38 states allow one-party consent (you are the consenting party). Check your state law before recording.
Written communications
- Save every letter, email, and text message
- Note the date received and any threatening or misleading language
- Screenshot texts and DMs before they can be deleted
Third-party contacts
- If the collector contacted your family, employer, or friends, get a written statement from that person noting what was said, when, and by whom
- Third-party disclosure of your debt (beyond one location-only contact) is an FDCPA violation
5. Filing complaints that get results
Filing complaints creates a paper trail, triggers regulatory investigations, and strengthens any future lawsuit. File with all three agencies:
| Agency | What they do | How to file |
|---|---|---|
| CFPB | Forwards your complaint to the collector (they must respond within 15 days), investigates patterns | consumerfinance.gov/complaint |
| FTC | Tracks complaints to identify repeat offenders, brings enforcement actions | reportfraud.ftc.gov |
| State Attorney General | Enforces state consumer protection laws (often stricter than federal) | Search "[your state] attorney general consumer complaint" |
When filing, include:
- The collector's name, address, and phone number
- Your account number
- Specific dates and times of violations
- Description of what happened (threats, illegal hours, third-party disclosure, etc.)
- Copies of any evidence (call logs, voicemails, letters)
If the harassment was severe or ongoing, consider consulting a consumer rights attorney. FDCPA lawsuits can recover up to $1,000 in statutory damages plus actual damages, and the collector pays your attorney fees if you win. Many consumer attorneys take these cases on contingency.
6. What happens after you stop the calls
Stopping the calls gives you space to address the underlying debt on your terms. Here is your decision tree:
- Check if the bill was correct. Upload your original bill to BillKarma to find billing errors, duplicate charges, or insurance gaps. Errors in the original bill mean the collection amount is wrong.
- Check the statute of limitations. Use our SOL calculator to see if the debt is time-barred in your state. If it is, the collector cannot sue you.
- Apply for financial assistance. If the bill is from a nonprofit hospital, you may qualify for charity care that writes off 50-100% of the balance — even after it went to collections.
- Negotiate a settlement. Collectors buy debt for 4-7 cents on the dollar. Offer 25-40% as a lump sum. Use our settlement letter tool to draft a protective offer.
- If sued, respond. Stopping calls does not prevent a lawsuit. If served with a summons, respond within the deadline and raise your defenses.
7. Real examples of stopped harassment
Case 1: 22 calls in one week — CFPB complaint led to $1,000 settlement
A patient received 22 calls in 7 days from a collector about a $2,800 hospital bill — more than 3x the legal limit. The patient documented every call with screenshots and filed complaints with the CFPB and state AG. A consumer attorney took the case on contingency and sent a demand letter citing Regulation F violations.
The collector settled for $1,000 in statutory damages plus agreed to drop the $2,800 debt entirely to avoid further legal action.
Result: $2,800 debt eliminated plus $1,000 paid to the patient.
Case 2: Collector called patient's elderly mother — third-party disclosure
A collector called a patient's 78-year-old mother and told her that her daughter owed $4,500 in medical debt and "needed to take care of it." This is a clear FDCPA violation — collectors cannot disclose your debt to third parties. The patient filed CFPB and state AG complaints and provided her mother's written statement.
The collector agreed to cease all contact, remove the debt from credit bureaus, and settle the $4,500 balance for $900 (20%).
Total savings: $3,600 on the debt. Third-party violation resolved.
Case 3: Workplace calls continued after objection — wage garnishment threat
A patient told a collector not to call their workplace. The collector called two more times and told the receptionist it was about "an urgent financial matter." On the second call, the collector told the patient "we will garnish your wages next week" — despite having no court judgment. The patient documented the calls, sent a cease-and-desist letter, and filed a complaint.
A consumer attorney sent a demand letter citing workplace contact violations (§ 1692c(a)(3)) and the false wage garnishment threat (§ 1692e). The collector settled for $2,500 in damages and ceased all collection on the $3,200 debt.
Result: $3,200 debt dropped, $2,500 in damages paid to patient.
Frequently asked questions
How do I stop a debt collector from calling me about medical bills?
Send a written cease-and-desist letter via certified mail. Under the FDCPA, once the collector receives it, they can only contact you by mail and only to confirm they are stopping contact or to notify you of legal action. Keep a copy of the letter and the certified mail receipt. Our letter generator can create and mail this letter for you.
How many times per day can a medical debt collector call me?
Under Regulation F, collectors are limited to 7 call attempts per debt in a 7-day period. There is no specific per-day limit, but calling repeatedly in a short period (e.g., 5 times in one hour) with intent to harass is still an FDCPA violation. After you have a phone conversation about the debt, they cannot call about that debt for 7 days.
Can a debt collector leave a voicemail about medical debt?
Yes, but the voicemail must comply with FDCPA rules. It must identify the caller as a debt collector and provide a callback number. It cannot disclose the debt details in a way that a third party could hear (e.g., a detailed message on a shared home phone). Save any voicemails that include threats, profanity, or debt disclosure — they are evidence of violations.
Can I block a debt collector's phone number?
You can block their number on your phone as a practical measure, but this is not a legal solution. The collector may call from different numbers or escalate to lawsuits. The legally binding way to stop calls is a written cease-and-desist letter sent via certified mail. Blocking is a supplement, not a replacement.
What should I do if a medical debt collector threatens me?
Document everything immediately — date, time, caller's name, company, and exactly what was said. Save voicemails and screenshot call logs. Then file complaints with the CFPB, FTC, and your state attorney general. Threats of arrest, violence, or legal action the collector does not intend to take are FDCPA violations. You can sue for damages.
Sources
- CFPB: Regulation F — Debt Collection Call Limits and Communication Rules (2021)
- FTC: Fair Debt Collection Practices Act (15 U.S.C. § 1692)
- CFPB: Consumer Response Annual Report — Debt Collection Complaints (2024)
- CFPB: Medical Debt and Consumer Protection Report
- National Consumer Law Center: Debt Collection Practices
- CMS Medicare Physician Fee Schedule (2026)