How to Dispute a Medical Bill: Complete Step-by-Step Guide

Every patient has the legal right to dispute medical bill errors. Under federal and state consumer protection laws, you can challenge charges you believe are incorrect, duplicated, or unfair. Medical billing errors occur in approximately 80% of hospital bills according to industry studies.

Your first action should be requesting a detailed, itemized bill. This document lists every service, supply, and charge using CPT codes. Without an itemized bill, you cannot identify specific errors. Call the billing department and request this in writing. They must provide it within 30 days.

Check your itemized bill for duplicate charges (same service billed twice), upcoding (charged for more expensive procedure than received), unbundling (services that should be one charge split into multiple), services not received, and incorrect quantities or dates.

If you have insurance, compare the itemized bill to your Explanation of Benefits (EOB). Check that discounts and in-network rates are applied correctly, verify services match what your insurance shows, and confirm any payments made by insurance are credited.

Compare your charges to Medicare rates and typical costs for your area. If charges are significantly above normal rates, you have grounds for negotiation. Use CPT code lookup tools to understand what each charge represents.

Send a written dispute letter via certified mail to create a paper trail. Include your account number, specific charges disputed with CPT codes, reason for dispute, supporting evidence, and desired resolution. Keep copies of everything.

Mark your calendar for follow-up calls if you don't receive a response within 30 days. Document all phone calls including date, time, representative name, and what was discussed. Escalate to supervisors if frontline staff cannot resolve.

If internal dispute resolution fails, file complaints with your state Attorney General, state Insurance Commissioner (for insurance-related issues), Consumer Financial Protection Bureau, and consider consulting a patient advocate or healthcare attorney.