Comparison-shopping between doctors and hospitals isn't always possible. Not only do fees vary widely, but health care providers typically do not explain costs ahead of time. This is one reason a 2014 NerdWallet study reported that 63 percent of Americans say they've received medical bills with a total balance higher they expected. Add to this an average billing error rate of about 49 percent, and it's clear that it is vital to not only review medical bills carefully, but also dispute incorrect or excessive charges.
Keep detailed records for any health care services you receive, as well as receipts for coinsurance and co-payments. If the bill you receive lists only total amounts, contact the doctor or hospital and ask for an itemized bill that includes every item and service for which you are being charged. Compare the itemized bill to your own records, and if you have health insurance, also to the Explanation of Benefits form you received from your insurance company. If the bill is correct, the items and services you received and the amounts listed on your records and the EOB should match those listed on the bill. If it doesn't, list every item, service and charge that doesn't match.
Contacting Appropriate Parties
Contact your insurance company to dispute a charge covered and paid for by your health insurance plan. This not only helps your insurance company keep costs in line, but may also reduce your coinsurance bill. Contact the doctor or hospital for charges not covered by your health insurance plan or that you are responsible for paying if you are uninsured. Instead of contacting your health care provider by telephone, send a notice in writing to the address and contact person listed in the billing inquires section of your bill.
Write a dispute letter in a business letter format. In the first paragraph, specify the errors or excessive charges uncovered during your billing review. Include supporting documentation, such as a copy of the bill in which you identify double charges or math errors. In the second paragraph, tell the health care provider that per your rights under the Fair Credit Debt Collections Act, if the health care provider reports the bill to any credit reporting agency, it must report the bill as being in dispute. Send the letter via certified mail with a return receipt.
Escalating a Dispute
If the health care provider either does not respond or does not send you a corrected bill with 30 to 45 days, send a second letter in which you state the letter is a second contact. If you still receive no satisfaction, file a complaint with the consumer protection agency or the Attorney General office for your state.
- NerdWallet: NerdWallet Health Study; Medical Debt Crisis Worsening Despite Policy Advances
- Fair Health Consumer Cost Lookup: Understanding Your Medical Bill
- Medical Billing Advocacy: How to Dispute a Hospital Bill
- Bronx Law Guide: How to Fight a Doctor or Hospital Bill
- Fair Health Consumer Cost Lookup: Understanding Your Explanation of Benefits (EOB)
- Bronx Law Guide: Sample Doctor Dispute Letter
- Bronx Law Guide: Sample Hospital Dispute Letter
- USA.gov: Consumer Protection Offices