NPAS Solutions on Your Credit Report: Your Options Explained

NPAS Solutions, also known as National Patient Account Services, Inc., is a Louisville, Kentucky medical debt collection agency and direct subsidiary of HCA Healthcare, one of the largest for-profit hospital systems in the United States.

The agency has accumulated nearly 20 federal lawsuits, with documented complaint patterns including threatening arrest without a court judgment, collecting on debts already paid, and leaving voicemails that fail to identify the caller as a debt collector.

A 2021 Sixth Circuit case involving NPAS voicemails was dismissed for lack of standing rather than on the merits, leaving the underlying conduct unresolved.

Who Is NPAS Solutions?

NPAS Solutions is the collection arm of National Patient Account Services, Inc., founded in 1980 in Louisville, Kentucky. The company is a direct subsidiary of HCA Healthcare and provides patient billing portals, billing process services, and debt collection to HCA-affiliated hospitals and other healthcare facilities.

NPAS is not BBB-accredited and operates out of three locations in Louisville, Kentucky and Earth City, Missouri.

Who Does NPAS Collect For?

NPAS focuses exclusively on medical and healthcare receivables. Confirmed clients from BBB complaint documentation and published sources include:

• HCA Healthcare facilities broadly: As an HCA subsidiary, NPAS handles collections for the full HCA hospital network across dozens of states.
• Henrico Doctors’ Hospital (Virginia): Documented in consumer complaints describing incorrect billing and misapplied payments.
• HCA Houston Healthcare Mainland (Texas): Documented in consumer complaints.
• Kershaw Health (South Carolina): Documented in a BBB review describing NPAS failing to process multiple monthly payments.

Ward v. NPAS Solutions: The 2021 Sixth Circuit Case

Ward v. National Patient Account Services Solutions (6th Circuit, No. 20-5902, 2021) alleged NPAS voicemails failed to identify the caller as a debt collector and failed to use its true business name, both FDCPA Section 1692e(11) violations. The Sixth Circuit dismissed for lack of Article III standing, not on the merits. The underlying voicemail conduct was not cleared by the dismissal.

Common NPAS Complaint Patterns

NPAS complaint records surface specific recurring issues tied to its collection conduct.

• Threatening arrest and immediate wage garnishment without a court judgment: A documented case settled for $2,100 after NPAS threatened a consumer with immediate arrest and wage garnishment. Wage garnishment requires a court judgment first.
• Misapplying payments to wrong hospitals: A documented complaint describes a consumer who paid $1,383.25 by phone, with the payment routed to a Colorado hospital the consumer had never visited instead of the Virginia hospital where they were treated. NPAS continued pursuing the balance despite proof of payment.
• Failing to process payments then pursuing collection: A documented BBB review describes monthly payments that NPAS did not process, followed by continued collection contact and an inaccessible phone system.
• Collecting debts from hospitals the consumer never visited: A documented complaint describes a cancer patient receiving billing demands for services at a hospital she had never attended.
• Leaving voicemails without identifying as a debt collector: The Ward case specifically documents this allegation, and multiple consumer complaints describe the same experience.

What NPAS Cannot Do Under Federal Law

• Threaten arrest or immediate wage garnishment without a court judgment: The $2,100 settlement documents this conduct. Both threats violate FDCPA Sections 1692e(4) and 1692e(5).
• Leave voicemails without disclosing debt collector identity: The Ward case alleged this conduct. FDCPA Section 1692e(11) applies to every communication including voicemails.
• Continue collecting on debts already paid: If a payment was made directly to the HCA facility or misapplied, continued collection is improper.
• Continue collection after a written validation request: All activity must pause until NPAS produces documentation.

Medical Debt Reporting Protections

Credit bureau voluntary policy changes effective 2023 removed paid medical balances and balances under $500 from credit reports. If NPAS is reporting a paid balance or a balance under $500, dispute those entries directly with all three bureaus without waiting for NPAS to act.

Verify Before Paying NPAS

Send a certified validation letter demanding the original HCA facility name, the itemized bill with CPT codes, the insurance Explanation of Benefits, proof insurance was billed before referral to NPAS, and written confirmation that all previous payments were applied to the correct account. If a payment was previously misapplied, include your payment documentation and demand a written accounting.

How to Check Your Credit Report

Pull all three reports at AnnualCreditReport.com and look for NPAS Solutions or National Patient Account Services as the furnisher. Confirm the original HCA facility, service date, and balance. Verify that the facility named is one you actually visited.

How Long Can NPAS Legally Pursue the Debt?

Kentucky allows five years on most written contracts. The state where you received treatment controls the statute.

Your Options for Resolving the Account

• Document any NPAS voicemail that did not identify the caller as a debt collector: Note the date, time, and phone number. The Ward 6th Circuit case targeted this specific conduct.
• Produce payment proof immediately for misapplied payments: Send a certified letter with payment documentation and demand a written accounting of where the payment was applied.
• Dispute entries for hospitals you never visited: File disputes with all three bureaus and a CFPB complaint. The cancer patient complaint shows NPAS has pursued consumers for debts at hospitals they had no connection to.
• File a CFPB complaint for arrest or garnishment threats: The $2,100 settlement documents that NPAS has made false threats. Document any such threat and report it immediately.

How to Contact NPAS Solutions

Handle all communication in writing. Send disputes by certified mail with return receipt requested:

• Louisville address: NPAS Solutions, 2700 Blankenbaker Pkwy, Suite 100, Louisville, KY 40299
• Louisville address: NPAS Solutions, 13906 Promenade Green Way, Suite 300, Louisville, KY 40245
• Earth City address: NPAS Solutions, 111 Corporate Office Drive, Suite 200, Earth City, MO 63045
• Phone: (800) 223-9899

Bottom Line

NPAS Solutions is an HCA Healthcare subsidiary with nearly 20 federal lawsuits, a documented $2,100 settlement for threatening arrest and wage garnishment, and a documented pattern of misapplying payments to wrong hospitals and pursuing consumers for debts from facilities they never visited.

If NPAS is collecting a balance you already paid, produce your payment proof immediately in writing. If NPAS threatened arrest or immediate wage garnishment, document it and file a CFPB complaint.

If an NPAS account is on your credit file, the right move depends on whether the original facility is one you actually visited, whether any payments were properly applied, and whether insurance was billed before the account was referred to NPAS.