I refused to sign anything, they billed it to DHS, DHS refused it and put that I was the responsible party, then the hospital sold it to debt collectors under my name.
(I've never done it, but I suspect you could get rid of a significant percentage of real debts like this, just on the strength of the industry's terrible record keeping practices.)
Just something I deal with every year or two, doing the process over again every time they resell it.