I had a bill in March of 2021 from a Baptist standalone ER for 700ish dollars.

I had shitty, substandard service for a bad puncture wound and they would not prescribe even the smallest amount of narcotics for the recovery period even though I have a clean medical history and was clearly not drug-seeking due to the emergent nature of my injury.

I let it go for six months. They called every day but I set my phone to only let known callers through so it wasn't bad. The one time I spoke with them they offered me a 40 dollar a month or so payment plan with no interest for a few years which I declined. They said they did not offer income based repayment which I was trying to look into as I was underemployed at the time.

About two weeks shy of the 6 month date they transferred my balance to their debt collection service. I called and they immediately offered me 20% off the total bill if I paid it in full that day. I didn't want it affecting my credit and wasn't sure that it wouldn't after 6 months so I went ahead and paid it.

If it was a larger amount I would've gone to someone in person if possible to discuss my particular options. I was bit by a pitbull and my leg was mangled so I was also hoping that the asshole dog owner would pony up for my medical expenses while this was going on.

TL:DR - At least 20% off in my case but I had to wait 6 months and a lot of debt collection calls to get there