When does an $11 charge cost $4,500? When it's an old medical bill, that's when. Mortgage brokers and lenders are reporting that these tiny amounts, often bills the homeowner is completely unaware of, are costing people the chance of refinancing to a lower mortgage rate or are adding thousands to the fees.

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Here's a typical case: The homeowner goes to the doctor and is told that she will be billed for any balance after both of her insurance companies pay their share. Months go by and the doctor visit is completely forgotten. As if often the case, the medical billing form drops the ball, and the doctor's office changes firms. Two years later, the third billing firm's computer kicks out a statement that never makes its way to the homeowner. It turns up years after the fact when the homeowner applies for a refinance and discovers that this "collection" has caused her credit rating to drop from 757 to 682. Suddenly the fees on a $300,000 refinance balloon from $0 to 1.5 points, or $4,500!

Inaccurate, disputed, and or just plain missed medical charges have been turning up all over and derailing refinancing nationwide according to many industry insider and the Washington Post. Why is this a factor now? Because of risk-based pricing, which was implemented in recent years and adjusts what people pay for a refinance according to their credit scores and other factors.

If you think this may be a problem for you, there is some potential relief on the horizon, A bill wending its way through Congress could provide relief for homeowners with medical-debt troubles. The Medical Debt Relief Act, which passed the House this fall and is now in the Senate, would remove settled medical debt from credit reports after 45 days, instead of the customary seven years.