How to Dispute Errors on Medical Bills



How to Dispute Errors on Medical Bills

Getting a medical bill with errors or charges that seem too high can be frustrating. But there are steps you can take to dispute those bills and hopefully reduce what you end up paying. This article will walk through the process step-by-step, so you can feel empowered to contest those medical bills.

Get an itemized bill

The first thing to do when you get a medical bill that seems incorrect is to request an itemized bill. This lists out each individual charge line-by-line so you can review the details. Sometimes the summary bills just show a total due amount, which doesn’t allow you to see what the charges are for.

Call the billing department for whichever provider sent the bill – whether it’s the hospital, doctor’s office, lab, etc. – and ask them to send you an itemized bill. This will allow you to verify that you received each of the listed services and that there are no duplicate charges or errors.

Review the itemized bill closely

Once you receive the itemized medical bill, it’s time to carefully review each charge. Here are some things to look out for:

  • Services you didn’t receive – If you’re being charged for tests or procedures you never got, that’s a clear error to dispute.
  • Duplicate charges – Check for the same service listed twice and charged twice. This is one of the most common medical billing errors.
  • Incorrect date of service – Verify the date of service matches when you were seen by that provider.
  • Wrong patient – Make sure the charges are for services you received, not another family member.
  • Incorrect calculations – Double check the math on the charges and make sure there are no typos resulting in higher amounts.

If you find any discrepancies like these, circle or highlight them on your bill so you can point them out when you call to dispute the charges. Having the specifics will make the process much easier.

Contact your medical provider

After you’ve identified any concerning charges on your itemized medical bill, it’s time to contact your provider. Call the billing office and explain what errors you found on your bill and that you would like to dispute those specific charges.

Having the details handy will help you easily explain the issues. Point out any services you didn’t receive and what date you actually were seen if there is an incorrect date of service listed. The billing representative will likely submit your concerns to their auditing department for review.

It can also be helpful to have your Explanation of Benefits from your health insurance provider on hand when you call. The EOB outlines what your insurance covered for the services, so it can provide back-up details if charges don’t align between the two.

Be patient but persistent when following up on disputed medical bills. It can take time for the provider to review but keep calling every week or so until it’s resolved. If the provider ends up agreeing that errors were made, they will send a corrected bill reflecting the accurate charges. Make sure to review this updated bill as well to verify it was adjusted properly.

Negotiate with medical providers

If the provider disagrees that any errors were made, try negotiating with them. For example, you may be able to get them to reduce the bill by agreeing to pay it quickly in cash rather than going through insurance.

Many medical providers are willing to provide a “cash discount” of 10-30% if you pay the bill quickly out of pocket rather than having them pursue payment from your health insurance company. This saves them administrative time and overhead.

You can simply ask politely if they’re able to provide any discount on the bill if you pay immediately, such as “Would you be able to offer a 20% discount on this bill if I pay the full amount today?” See what they’re willing to do – it never hurts to ask!

Dispute medical bills with your insurance

If there are charges your provider is unwilling to adjust, your next step is contacting your health insurance company. They will be able to go through the claim in more detail and fight the charges for you.

Call the customer service number on the back of your insurance card and explain that you have a medical bill you believe contains errors. Provide details on which specific charges you dispute and why. The insurance representative can submit an appeal or audit on your behalf.

It will help your appeal if you have already contacted the provider and attempted to dispute the bill with them first. Your insurance company may even be willing to negotiate a lower payment on your behalf if the provider refuses to adjust the charges.

Ask for financial assistance

If you’ve disputed the questionable charges but the bill still remains unaffordably high, ask your medical provider about financial assistance programs. Most hospitals and health systems offer financial assistance or charity care programs for patients who meet income requirements.

Call the billing office and explain your situation – that you don’t have the means to pay the full bill even after insurance. Ask what types of financial assistance or payment plans they offer. With many medical bills, you also have the option to set up interest-free payment installment plans over 6-12 months.

Non-profit hospitals are required to have financial assistance policies and offer free or discounted care based on your income level and family size. But never assume you won’t qualify – it’s always worth applying if a medical bill is beyond your means.

Avoid medical bill collections

If despite your best efforts the disputed medical bill gets sent to collections, don’t panic. You still have options before it goes on your credit report.

First, ask the collection agency to validate the debt. They are required to provide proof that the amount they are trying to collect is accurate and belongs to you. If they can’t provide evidence that it’s a legitimate debt, they must stop collections activities.

You can also negotiate with collections agencies and in many cases settle medical bills for much less than the full balance. A settlement looks better on your credit than an unpaid collection account.

Be aware that medical bills generally won’t appear on your credit report until they have gone through the collections process. Paying directly to your provider typically will not impact your credit score.

Watch out for medical billing scams

With medical bills, it’s important to watch out for potential scams. Some signs a medical collections call could be fraudulent:

  • They want you to pay over the phone immediately with a credit card or wire transfer
  • They threaten arrest or other legal action if you don’t pay right away
  • They say they can settle the debt for pennies on the dollar
  • You don’t recognize the name of the provider or collection agency

A legitimate collector won’t pressure you to pay immediately over the phone or make legal threats. Hang up if you suspect a scam.

Dispute errors on your credit report

If a medical bill does end up on your credit report incorrectly, you have the right to dispute it. Submit disputes online or in writing to all three credit bureaus – Equifax, Experian and TransUnion. Explain why the information is inaccurate and provide any documentation.

The credit bureau must investigate within 30 days unless they consider your dispute “frivolous.” Keep an eye on your credit report to ensure the error gets removed. If not, you can ask the credit bureau to review your dispute again.

Persistence and meticulous records are key when contesting medical bills. But with time and patience, you can get those errors corrected and hopefully reduce the amount owed. Don’t be afraid to be your own advocate and speak up when charges don’t look right.

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