Before You Dispute a Medical Bill: What to Gather

A medical bill is easier to question when your papers are in one place. This page shows you what to collect. It gives you words to say on the phone. And it shows what happens after you send a letter.

You do not need to understand every line on the bill. You only need to gather it. BillFighter reads it with you.

What to collect

Get these things together. Do not worry if you are missing some. You can ask for them. The phone script below shows you how.

• The bill. This is the paper or email that says how much they want you to pay.
• The itemized bill. This is a longer list. It shows every charge, one line at a time, with a billing code next to each one. The hospital must give it to you if you ask. Read: How to request an itemized bill.
• The EOB from your insurance. EOB means "Explanation of Benefits." It is a letter from your insurance company. It shows what they paid and what they say you still owe. It is not a bill.
• Any collection letter. This is a letter from a company that says it is now collecting the debt. Keep the envelope too. The postmark shows when it was mailed.
• Dates of service. These are the days you were seen or treated. They are printed on the bill and on the EOB.
• Your policy or member number. This is the number on your insurance card. It tells the insurance company who you are.
• Photos or scans of everything. Take a clear picture of every page, front and back. Keep the originals in one folder.

Your checklist

Print this page, or copy the list into your notes. Tick each one as you find it.

• ☐ The bill
• ☐ The itemized bill (or a note that you asked for it, with the date)
• ☐ The EOB from your insurance
• ☐ Any collection letter, with the envelope
• ☐ Dates of service
• ☐ Your policy or member number
• ☐ A photo or scan of every page
• ☐ A folder where all of this lives

What to say when you call the billing office

The phone number is on the bill. Before you call, have the bill in front of you. Have a pen and paper. Write down today's date.

1. Say who you are. "Hi. My name is ____. I am calling about account number ____."
2. Ask for the itemized bill. "Please send me an itemized bill. I want to see every charge on its own line, with the billing codes." Ask if they can email it or mail it. Write down which one.
3. Ask them to hold the account. "Can you put this account on hold while I review it? I do not want it sent to collections while I am looking at it." They may say yes or no. Write down what they say.
4. Ask for the financial assistance policy. "Please send me your financial assistance policy and the application form." Financial assistance is also called charity care. It is a hospital program that can lower a bill for people who cannot afford it. Read: How to apply for charity care.
5. Get the name and the date. "Can I have your name, please?" Write the name down next to today's date. Keep that note with your papers.

If they refuse something, stay calm. Say "Okay, thank you," and write down what they said. That note is useful later.

What happens after you send a letter

Here is the whole path, in order. Print it and keep it with your papers.

1. You send it. Send it by certified mail if you can. Certified mail means the post office gives you a receipt that proves you sent it. Keep the receipt.
2. You keep proof. Keep a copy of the letter, the receipt, and the date you mailed it. Put them in your folder.
3. You wait. Nobody can promise how fast they will answer. There is no set date by which they must write back. Do not count on a deadline. While you wait, keep any new mail that comes in.
4. You upload what they send back. When a reply comes, take a photo of every page. Upload it to your BillFighter case. BillFighter reads it and tells you, in plain words, what they said.
5. You decide the next step. Their reply decides what comes next. They may fix the bill. They may ask you for more papers. They may say no. Each one has a next letter, and BillFighter shows you which one fits.

When to get more help

Some problems need a person. Here is who to ask.

• The hospital's patient advocate. Most hospitals have one. This is a person whose job is to help patients with problems, including billing. Call the hospital's main number and ask for the patient advocate.
• Your state insurance department. If the problem is with your insurance company, your state has an office that handles complaints about insurers. Search for your state's name plus "department of insurance."
• Legal aid. Legal aid offices give free legal help to people with low income. If you get court papers, or a collector will not stop, call legal aid. Search for your state's name plus "legal aid."

BillFighter is not a law firm and cannot give you legal advice. We can help you get organized and write a clear letter.

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