10 tips for disputing a medical bill
Disputing incorrect medical bills can be frustrating but often leads to successful resolutions.
The following article was published online by The Charlotte Ledger, an e-newsletter with smart and original local news for Charlotte. We offer free and paid subscription plans. More info here.
From keeping detailed records to delaying payments to setting up 3-way calls, there are things you can do to improve your odds of success
by Michelle Crouch
Co-published with N.C. Health News
Disputing an unexpected or incorrect charge on a medical bill can be frustrating and time-consuming, but it can pay off.
A 2024 survey of North Carolina residents found that more than three-quarters (78%) of people who disputed an incorrect medical bill were able to resolve the issue in their favor.
Caitlin Donovan, senior director of the National Patient Advocate Foundation, shared these tips on how to successfully dispute a bill:
1. Get the itemized bill and scrutinize it.
Often, the first bill you receive from a health care provider has just one big number showing what you owe. Ask for an itemized bill that shows which services were provided and how they were coded. Then look for duplicate fees, charges for services you didn’t receive or other errors. Does the provider’s statement match up with the “explanation of benefits” from your insurance company? Was any of your care billed as “out-of-network” even though you went to an in-network provider?
2. Delay before you pay.
Sometimes, health care providers send you a bill before they’ve filed with your insurer, and it’s very difficult to get your money back once it’s in the hands of a hospital or debt collector. If you have debt already in collections, send a letter to the debt collector disputing the validity of the debt and asking for documentation verifying it. Federal law requires them to provide proof that the debt is yours, and you get 30 days to investigate and build your case before they can resume collection efforts.
3. Build your case.
Read the fine print of your health insurance policy to make sure you understand what’s covered and what’s not. If you’re fighting an insurance denial, ask why it was denied and how the service would need to be coded for it to be covered. (The Patient Advocate Foundation has tips for fighting insurance denials.)
4. Check to see if you qualify for financial assistance.
Don’t assume you don’t qualify; many hospitals offer aid even for those with higher incomes. Atrium Health, for example, offers discounts to uninsured patients whose annual income is at or below 400 percent of the federal poverty level — that’s $124,800 for a family of four. You may also qualify if what you owe is a large percentage of your income.
5. Keep good records.
Keep a record of when you have tests, scans and exams, and save copies of bills, letters and communication from your health care provider and your insurer. Get the name and confirmation number (or other identifying information) of people you talk to. Take screenshots of message exchanges in the portal. If your health insurer’s website shows your provider is in network, take a screenshot of that too. You’ll need documentation to make your case.
6. Be persistent.
If you’ve reached a dead end with the customer service agent you’re working with, call back and talk to someone different, or ask for a supervisor. If that person isn’t helpful, ask for the head of the department.
7. Set up a three-way call.
When Donovan was disputing one of her own medical bills, the provider and her health insurer gave her conflicting information, so she set up a three-way call to get everyone on the same page.
8. Ask for a discount.
If you ask, many hospitals will offer a discount if you offer to pay your whole bill immediately. You can also ask about an interest-free payment plan.
9. Consider posting a public complaint.
Some patients report that sharing a complaint on social media or on a public review site like Yelp or Google Reviews can be the nudge a hospital system needs to take concerns seriously.
10. Get help.
If you don’t have the time or energy to fight a big or complicated bill, consider getting help from a patient advocate. Some employers offer patient advocacy services as a staff benefit. The Patient Advocate Foundation provides free help to U.S. patients who have a diagnosed debilitating or critical condition, except for bills related to mental illness, accidents or maternity care. Or hire a professional patient advocate; they typically take a percentage of what they save you.
—
Michelle Crouch covers health care. Reach her at mcrouch@northcarolinahealthnews.org. This article is part of a partnership between The Ledger and North Carolina Health News to produce original health care reporting focused on the Charlotte area.
Need to sign up for this e-newsletter? We offer a free version, as well as paid memberships for full access to all 4 of our local newsletters:
➡️ Opt in or out of different newsletters on your “My Account” page.
➡️ Learn more about The Charlotte Ledger
The Charlotte Ledger is a locally owned media company that delivers smart and essential news through e-newsletters and on a website. We strive for fairness and accuracy and will correct all known errors. The content reflects the independent editorial judgment of The Charlotte Ledger. Any advertising, paid marketing, or sponsored content will be clearly labeled.
Like what we are doing? Feel free to forward this along and to tell a friend.
Social media: On Facebook, Instagram, Twitter and LinkedIn.
Sponsorship information/customer service: email support@cltledger.com.
Executive editor: Tony Mecia; Managing editor: Cristina Bolling; Staff writer: Lindsey Banks; Business manager: Brie Chrisman