How to Dispute a Medical Bill (and Win)

Medical Billing Errors Are Extremely Common

Studies show that up to 80 percent of medical bills contain errors. Common mistakes include being billed for services you did not receive, duplicate charges for the same procedure, incorrect coding that results in higher charges, being charged the uninsured rate when you have insurance, and being billed for a longer hospital stay than your actual visit. Always review your bill carefully before paying.

Step 1: Request an Itemized Bill

Call the billing department and request a fully itemized bill, not just a summary. The itemized bill shows every individual charge with CPT codes (procedure codes) and descriptions. Compare this against your records of what actually happened during your visit. Look for procedures you did not receive, charges listed more than once, charges for time periods you were not there, and supplies or medications you were not given.

Step 2: Compare Against Your Insurance EOB

Your insurance company sends an Explanation of Benefits after processing each claim. Compare the EOB against the hospital bill. Check that the insurance payment and your responsibility match what the hospital is billing you. If the hospital is billing you more than the EOB says you owe, contact the billing department and point out the discrepancy. Also check that in-network rates were applied if you used an in-network provider.

Step 3: Negotiate the Balance

Hospitals and medical providers regularly accept less than the billed amount. Call the billing department and ask about financial assistance programs. Ask if they offer a prompt-pay discount for paying in full, which is typically 10 to 30 percent off. Request a payment plan at zero interest. If the bill is very large, ask to negotiate the total. Many hospitals will accept 40 to 60 percent of the original bill rather than risk the patient not paying at all or declaring bankruptcy.

Can a medical bill go to collections while I am disputing it?

Technically yes, but you can prevent this by calling the billing department and requesting that the account be placed on hold during the dispute. Put your dispute in writing and send it via certified mail. Under the Fair Debt Collection Practices Act, once you dispute a debt in writing, the collector must stop collection efforts until they verify the debt.