Payment arrangements on medical bill

I owe around $6000 to few doctors and hospitals. I’ve been able to work out payment arrangements with 2 of them. But the third one has said nothing when I made the proposal. I’ve a problem with the fourth bill. I had sent them an amount on the bill but after few days I got back the amount with a letter stating that I needed to make a different arrangement. So am I wrong in thinking that if they refuse a partial payment on the bill, would the bill be considered as paid in full?
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