[mindslight]

The thing they have you sign is a single-party "consent" and not a two-party "contract", implying it's merely informing you about what they are able to do to you, rather than asking you to assent to a purportedly mutual agreement.

I cross out all that unilateral nonsense about being financially responsible (as well as other types of nonsense), and have never been balked at. Worst case is these days when they ask me to sign a contextless touchpad, and then they roll their eyes like it's some big imposition when I ask for a hard copy instead so I can "review".

So I don't think that paperwork is directly involved with how the medical industry has come to run on billing fraud shakedowns. Hence asking for actual mechanics / outcomes of what happens when people are "sent a bill" and don't do the implied thing of just paying it.

Also, have you ever talked to an attorney - especially asking them preemptive or against-the-status-quo questions? In my experience they generally tell you to just go with the flow. If they advise you to do anything else and it blows up, then they themselves could be on the hook.