Hospital patients waiting in the emergency room or convalescing after surgery could find themselves confronted by an unexpected visitor: a debt collector at bedside.

In November, Marcia Newton was shocked when she was forced to pay for her son Maxx’s ear tube surgery at Fairview Hospital even before he went into the hospital room.

One of the nation’s largest medical debt-collection companies is under fire in Minnesota for having placed its employees in emergency rooms and other departments at two hospitals and demanding that patients pay before receiving treatment, according to documents released Tuesday by the Minnesota attorney general. The documents say the company also used patient health records to wrangle for more money on overdue bills.

The company, Accretive Health, has contracts not only with the two hospitals cited in Minnesota but also with some of the largest hospital systems in the country, including Henry Ford Health System in Michigan and Intermountain Healthcare in Utah. Since January, it has faced a civil lawsuit filed by Attorney General Lori Swanson of Minnesota alleging that it violated state and federal debt-collection laws and patient privacy protections.

Ms. Swanson, though not bringing further charges on Tuesday, said she was in discussions with state and federal regulators to prompt a widespread crackdown on Accretive Health’s practices in other states.

‘I have every reason to believe that what they are doing in Minnesota is simply company practice,’ she said in an interview, but declined to be more specific.

An Accretive Health spokeswoman declined to comment on whether other states were looking into its practices. ‘We have a great track record of helping hospitals enhance their quality of care,’ she said.

But hundreds of internal company documents released by the attorney general’s office cast a spotlight on the increasingly aggressive medical-collection techniques used against patients at hospitals across the country.

As a growing number of hospitals struggle under a glut of unpaid bills, they are turning to companies like Accretive. To win promised savings, all hospitals have to do is turn over the management of their front-line staffing — ranging from patient registration to scheduling and billing — and their back-office collection activities. Accretive says it has such arrangements with some of the country’s largest hospital systems to help reduce their costs.

Indistinguishable from medical staff members, Accretive employees register patients, take down sensitive health information and champion aggressive bill collection goals with incentives like gift cards for staff members, the company records show.

‘It is absolutely stunning that the company has systematically trampled on patient rights, perverting the charitable mission of a hospital,’ Ms. Swanson said in an interview.

Accretive is one of a group of debt-collection companies specializing in health care collection. Last year, the publicly traded company reported $29.2 million in net income, up 130 percent from a year earlier.

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I am a Canadian. I have lived in America for the last several years. I find the health care system in this country APPALLING.

It’s about profits over people. Who the hell cares if the health of citizens is improving (it isn’t), so long as we keep the money rolling in, they can die in the street.

That’s the attitude. It’s horrid and yet there is a group of people who want to VEHEMENTLY support and DEFEND this system.

The mind boggles.