Overseas patients owe more than �500,000 in unpaid hospital bills.
It is estimated more than 200 patients owe money to Leicester's hospitals, although some claims are being dealt with through insurance companies.
In the past 12 months, 63 cases – in which more than �100,000 is owing – have been referred to a debt collection agency as managers at University Hospitals of Leicester NHS Trust tried to recoup some of the costs.
The agency chases debtors by telephone and letter.
It has links with the UK Border Agency and overseas debt collection agencies that are used to help recover money which is due.
The trust said it had staff who identified overseas patients and, where they were liable, tried to get payment before or at the time of treatment.
It said: "Where this is not possible, invoices are raised to the patient after treatment."
Overseas visitors are entitled to free medical treatment in the accident and emergency department but have to pay if they are admitted to hospital or need to be seen as an outpatient. They are charged what it would cost the NHS for a treatment.
Visitors from most European countries do not have to pay as arrangements are in place to make sure the hospitals' trust is reimbursed.
Andrew Sneddon, director of finance at the trust, said: "Our priority is delivering emergency care to those who need it.
"All overseas visitors are entitled to free emergency treatment in the accident and emergency department.
"However, if they are admitted to a ward or given an outpatient appointment they then become liable for the cost of their treatment unless they are exempt."
Those exempt from charges include anyone working in the UK for a local employer, full-time students on courses lasting at least six months or a shorter course if it is substantially funded by the Government and refugees and asylum seekers.
In the past year, the trust has provided �2.1 million of treatment to overseas patients. Of this, �1.7 million, has been recovered through reciprocal payment arrangements.
Money is also owed by patients treated in previous years.
David Gorrod, a member of the Leicester Mercury patients' panel, said: "Everyone would understand that emergency treatment cannot, and indeed should not, be withheld.
"However, it does seem that there are a number of people abusing the NHS ,which is paid for by taxpayers in this country.
"It is unacceptable that, other than in an emergency, these patients should not pay for their treatment.
"One would hope Leicester's hospitals would spare no effort in recovering debt where it is due."
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