Wow, Emily !- it sure looks like the hospital's accounting department may have messed up somehow. Common sense would suggest that they give you some leeway after not sending statements for such a long time. When I was helping my son send payments to all the different hospital departments and it got pretty difficult, their nice Account Dept lady told us we could pay even very small amounts each month. Most hospitals can accommodate patients with lower payments when the need arises. When you call, ask to speak to someone regarding what seems to be an accounting problem. Be very sweet and get the name of the person, in case you have to call back later. Explain how the large bill will create a hardship for you if you have to pay it all at once and ask if they can help you in some way. Most important: EXPECT a positive outcome . . . it could happen!