Before You Dispute a Medical Bill: What to Gather

Before you dispute a medical bill, gather six things: the bill, the itemized bill, the EOB from your insurance, any collection letter with its envelope, the dates of service, and your policy or member number. Take a photo of every page and keep it all in one folder. If a paper is missing, ask for it in writing.

A medical bill is easier to question when your papers are in one place. This page shows you what to collect. It shows you which letter asks for the papers you are missing. 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 section 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. You can ask the hospital for it. 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

How to ask for the papers you are missing

Ask in writing. A letter has a date on it, and a copy stays in your folder. A phone call leaves nothing behind. Certified mail is best, because the post office gives you a receipt.

Here is what each letter asks for. BillFighter writes them from your bill. You read each one, sign it, and mail it yourself, or have BillFighter send it by certified mail with the delivery record on file. Start with the free scan: Check my bill, free →

1. The itemized bill. You can ask for every charge on its own line, with the billing code next to it, for your account number. BillFighter's Request Itemized Bill letter asks for exactly this. Read: How to request an itemized bill.
2. A hold on the account. You can ask that the account stay out of collections while your request is open. They may say yes or no. Their answer goes in your folder. The Request Itemized Bill letter and the Dispute Letter both ask for this hold.
3. The 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. Nonprofit hospitals must post the policy and the form online, and must give you a paper copy free when you ask. BillFighter's Charity Care Application letter asks for both, and asks that collection pause while the hospital reviews it. Read: How to apply for charity care.

If you call. You do not have to call. If you do, to confirm the mailing address or to check that your letter arrived, ask them to send anything they tell you in writing. Then write down the date, the time, and the name of the person you spoke to. Keep that note with your papers. If they refuse something, write down what they said and when. 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 at the hospital whose job is to handle patient problems, including billing. If your letters get no answer, your follow-up can be addressed to that office. The hospital's website usually lists it under "patient advocate" or "patient relations."
• Your state insurance department. If the problem is with your insurance company, your state has an office that handles complaints about insurers. BillFighter's Insurance Commissioner Complaint letter is written for that office. It comes after your appeal, not before.
• 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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