ScrewedScore
Free Checklist
Medical Bill Dispute Checklist
Print this checklist and go through it line-by-line before paying any hospital or medical bill. Up to 80% of medical bills contain at least one error.
Red Flags — Check Each One
UpcodingYour 15-minute checkup billed as a 45-minute comprehensive exam. Request CPT codes and look each one up at cms.gov — if the description doesn't match what happened, dispute it.
Duplicate Charges"Blood draw" and "venipuncture" on the same bill are the same thing. "Consultation" and "evaluation and management" for the same visit are the same thing. Scan every line for services that sound identical.
UnbundlingOne procedure split into 3–4 separate line items, each billed individually. Total can be 2–3× what it should be. Common with lab work and surgical procedures.
Services Not RenderedScheduled physical therapy or other services that never happened but still appear on the bill. Compare your bill against your medical records — if a service is on the bill but not in your records, that's fraud.
Surprise Facility Fees$200–$800 "facility fee" because the doctor's office was technically on hospital property. Ask before any appointment: "Is this location billed as a hospital outpatient department?"
Dispute Steps — In Order
1
Request the itemized billCall the billing department and request a fully itemized bill with every CPT code. Hospitals are legally required to provide one in most states. The summary bill you received hides most errors.
2
Look up every CPT codeVisit cms.gov or the AMA code lookup. Compare each code's description to what actually happened. A mismatch is grounds for dispute.
3
Write a formal dispute letterIdentify each suspicious charge by line item and CPT code. Request documentation showing the service was rendered. Send via certified mail to create a paper trail.
4
Negotiate the remaining balanceAfter removing errors, the rest is negotiable. Hospitals frequently accept 40–60% of the remaining balance, especially for uninsured or underinsured patients.
5
Appeal through your insurerIf insurance denied a claim that should be covered, file a formal appeal. Insurers must respond within 30–60 days. External appeals succeed about 40% of the time.
Know Your Rights
You can dispute any chargeYou have the right to dispute any charge you believe is incorrect, even after paying. The statute of limitations on medical billing disputes is typically 3–6 years.
Medical debt under $500 is off credit reportsAs of 2023, medical debt under $500 no longer appears on credit reports. A bill under active dispute generally cannot be sent to collections.
Compare your bill to your EOBYour Explanation of Benefits (EOB) from your insurer shows what they were billed, what they paid, and what you owe. Discrepancies between your EOB and your bill are a red flag.