Got a medical bill that feels way too high—or just plain wrong?
You’re not alone. Medical billing errors are shockingly common, and many patients don’t realize they have the right to dispute charges they believe are incorrect or unfair.
In this guide, we’ll walk you through exactly how to spot errors, gather evidence, and challenge a medical bill—so you don’t pay more than you should.
🧾 Can You Legally Dispute a Medical Bill?
Yes. You have the right to dispute:
- Incorrect charges
- Duplicate charges
- Out-of-network charges you didn’t consent to
- Charges for services you didn’t receive
- Unreasonable or inflated pricing
Federal and state laws, including the No Surprises Act, give you some protections—especially if you have insurance.
🔍 Step 1: Review the Medical Bill Carefully
Before calling anyone, read your bill closely.
Check for:
- Procedures or services you didn’t receive
- Dates of service you weren’t treated
- Multiple charges for the same item (double billing)
- Coding errors (CPT or ICD codes that don’t match treatment)
💡 Tip: Request an itemized bill if you only received a summary.
📑 Step 2: Compare It With Your Insurance EOB
Your Explanation of Benefits (EOB) from your insurance company shows:
- What was billed
- What was covered
- What was denied
- What you’re expected to pay
Compare this to the medical provider’s bill. Look for:
- Discrepancies in amounts
- Services that weren’t covered (but should have been)
- Mistaken out-of-network charges
📞 Step 3: Call the Medical Provider’s Billing Department
Speak with the provider before contacting your insurer. Ask:
- Can they explain specific charges?
- Are any items coded incorrectly?
- Were charges submitted to the correct insurance?
🧠 Stay calm, polite, and take notes—document names, dates, and what was said.
📠 Step 4: Submit a Formal Dispute or Appeal
If the issue isn’t resolved by phone:
➤ For uninsured/self-pay patients:
- Write a dispute letter to the provider requesting a review
- Attach copies of your bill, notes, and any evidence
➤ For insured patients:
- File a formal appeal with your health insurance provider
- Follow their exact process and include:
- A letter explaining the issue
- Any supporting documents (EOBs, itemized bills, call logs)
🏛️ Step 5: Know Your Rights Under the No Surprises Act
The No Surprises Act (effective January 2022) protects patients from:
- Surprise out-of-network bills in emergencies
- Charges from out-of-network providers at in-network facilities
- Balance billing in certain situations
If your bill violates this law, file a complaint at: 👉 https://www.cms.gov/nosurprises
💼 Step 6: Consider Negotiating or Seeking Financial Assistance
Even if the bill is correct, you may still be able to:
- Negotiate a lower rate (especially if you’re uninsured)
- Request a payment plan
- Apply for financial assistance through the provider or hospital
Pro tip: Many billing offices are open to reductions if you ask the right way and show financial hardship.
⚖️ Step 7: Escalate If Needed
If your dispute or appeal is denied, you can escalate:
- Contact your state insurance commissioner
- File a complaint with the Consumer Financial Protection Bureau
- Consider hiring a medical billing advocate
- In serious cases, consult a healthcare attorney
✅ Final Thoughts
Medical bills can be confusing, overwhelming—and flat-out wrong. But you don’t have to accept them at face value.
By carefully reviewing your bill, knowing your rights, and taking a step-by-step approach, you can challenge inaccurate charges and reduce what you owe.
Don’t be afraid to speak up. Your wallet—and your rights—deserve protection.
