She could try and if they refuse, it's likely the CA will report it. Once it hits her reports, she can then use the HIPAA process. I work in healthcare (and chase payments, it's a BIG part of my job) and for the life of me, I can't understand why OC's won't accept a PIF on a past due account sometimes...it's stupid. Most but not all med accounts that are given to CAs are assigned and not sold, so the OC's on med collection should just be quite and accept the darn payment. Who in this forum, if owed money, would tell the person who owes them money, to pay someone else. Duh! What rubbish! LOL!