Medical bills are among the most confusing bills a household receives, and mistakes are not unusual: duplicate charges, services you did not receive, or claims processed under the wrong insurance information. Taking an hour to review a large bill can save real money.
Key Takeaways
- Ask for an itemised bill showing each charge, not just a summary.
- Compare it with your insurer’s explanation of benefits (EOB) before paying.
- Dispute errors in writing with both the provider and insurer.
- Nonprofit hospitals are required to have financial assistance policies; ask whether you qualify.
Wait for the EOB
After a visit, your insurer sends an explanation of benefits showing what was billed, what the plan paid and what you owe. The EOB is not a bill. Compare the provider’s bill with the EOB; the amount you owe should match.
Request an itemised bill
A summary bill may show only a total. Call the billing department and ask for an itemised statement listing each service, date and billing code.
What to look for
- Duplicate charges for the same service or supply.
- Services you did not receive, or a longer stay than you had.
- Incorrect dates or patient information.
- Charges for cancelled tests or procedures.
- Out-of-network charges for care you received at an in-network facility; the federal No Surprises Act protects against many surprise bills for emergency care and certain services at in-network facilities.
Disputing an error
- Call the provider’s billing office and explain the problem. Note the date, name and reference number.
- Follow up in writing with copies of the bill and EOB.
- If the claim was processed incorrectly, contact your insurer and ask for it to be reprocessed or file an appeal.
- Ask the provider to put the account on hold while the dispute is reviewed so it is not sent to collections.
Financial assistance
Nonprofit hospitals must have written financial assistance policies, and many offer free or discounted care based on income. Some for-profit hospitals and clinics offer assistance too. Ask for the application, even if you think your income is too high; thresholds can be higher than expected.
Negotiate and set up payment plans
- Ask whether there is a discount for paying in full.
- If you are uninsured, ask for the self-pay rate.
- Ask for an interest-free payment plan you can afford.
- Avoid putting large medical bills on a high-interest credit card when an interest-free plan is available.
Medical debt and credit reports
The major credit bureaus have stopped reporting paid medical collection debt and medical collections under $500. Rules on medical debt reporting have been changing, so check current guidance if a bill has gone to collections.
Keep records
Keep a folder with bills, EOBs, call notes and correspondence. If a dispute takes months, records make it much easier.
Frequently Asked Questions
Should I pay a bill while disputing it? Generally ask for the account to be put on hold during the dispute, and pay any amount you agree you owe.
What if my insurer denies a claim? You have the right to appeal. Follow the instructions on the denial letter and include supporting documentation from your provider.
Can I negotiate a bill after insurance? Yes. Providers often accept payment plans or reduced amounts, particularly for financial hardship.
The bottom line
Never pay a large medical bill without checking it against your EOB. Request an itemised statement, dispute mistakes in writing and ask about financial assistance and payment plans.
