To: Blah-blah Collection Agency
Re: Acct #9999999
Creditor: [provider's name]
Regarding: [patient's name]
I am writing in response to your letter dated xxxx, because I do not believe that I owe what you say I owe.
This is the first I've heard from you or any other company on this matter, therefore, in accordance with Section 809 - Validating Debts of the Fair Debt Collection Practices Act, I respectfully request that you provide me, in writing, the following:
• What the money you say I owe is for;
• Explain and show me how you calculated what you say I owe;
• Provide me with copies of any papers that show I agreed to pay what you say I owe;
• Identify the original creditor;
• Provide a verification or copy of any judgment (if applicable);
• Show me that you are licensed in my state, and provide me with your license numbers (if applicable).
Be advised that I am fully aware of my rights under the Fair Debt Collection Practices Act and the Fair Credit Reporting Act. For instance, I know that:
• You cannot add interest or fees except those allowed by the original contract and state law.
• You do not have to respond to this dispute except to tell me that you either intend to cease your collection efforts or to pursue other legal means of collecting this debt.
• Should you pursue a judgment without validating this debt, I will inform the judge and your case will be dismissed based on your failure to follow the FDCPA.
• Any attempt to collect this debt without validating it, violates the FDCPA. Be advised that I intend to record all phone calls, keep all correspondence and will not hesitate to report violations to my State Attorney General, the Federal Trade Commission and the Better Business Bureau.
I have disputed this debt; therefore, until validated you know your information concerning this debt is inaccurate. Thus, if you have already reported this debt to any credit-reporting agency (CRA) or Credit Bureau (CB) then, you must immediately inform them this debt is in dispute. Reporting information that you know to be inaccurate or failing to report information correctly violates the FCRA § 1681s-2.
If you do NOT own the rights to collect this debt, I demand that you immediately send a copy of this dispute letter to the original creditor that you say I owe money too so they are also aware of my dispute with this debt.
Finally, in accordance with section 805(c) - Ceasing Collections, of the Fair Debt Collection Act, do not contact me about this or any other matter, except by official mail and then only to advise me that your debt collection efforts are being terminated or that you are taking specific actions allowed by law.