How To Dispute a Medical Bill Effectively

FT Contributor  | 

Hospitals and insurers are humans too. This means they are capable of making mistakes, something that is extremely common with medical bills. From entering incorrect codes to overcharging for an incorrect procedure, medical billing can get messed up.

Whether a mistake was made or not, it’s important to understand that you can still dispute a bill to reduce your medical costs if you feel the need to do so. Below, we’ll explain step by step how you can effectively dispute your medical bills to either reduce the charge or receive a refund.

Why You Should Dispute a Medical Bill

There are a number of reasons someone would dispute a medical bill. Oftentimes medical providers and hospitals charge outrageous prices for minor treatments. If your insurance only covers a portion of the cost, you may want to dispute the bill to reduce what you owe out of pocket.

In other cases, an insurance provider may not have approved a doctor’s visit or procedure. This again leaves you with a hefty fee for medical treatment.

Further still, emergency rooms have become known for the excessive fees they charge. While emergency rooms are required to treat patients regardless of their ability to pay, that doesn’t mean those fees won’t sneak up on you later.

You’ll want to attempt to reduce your medical bill as much as you can. Regardless of why you want to dispute your medical bill, below you’ll find the tips to do so properly and effectively.

How to Dispute a Medical Bill

A number of steps must be completed in order to dispute a medical bill. If you have found a mistake on your bill or want to dispute the charge, here’s how to do it:

Take Notes

During this process, it’s vital to take notes so that you can be certain of details later down the line. Always have a pen and paper at the ready to keep track of names, dates, phone numbers, and exact expenses.

Additionally, you’ll want to know how to read your medical bill. Understanding what your medical bill says will allow you to better point out any mistakes, such as double charges or charges for something you didn’t receive.

Gather Evidence

When it comes to disputing medical bills, the process requires a lot of phone calls. You need to make sure you have every single piece of documentation on hand before you start calling people.

Before you place a call, gather all of the evidence you will need to dispute your claim. This might include previous bills from medical centers, labs, or doctor’s offices. If you do not have these at the ready, you may have to contact the proper medical facility and ask them for copies.

Overcharged hospital bills are very common, so they should be your first call. Make sure you ask the hospital for the correct bill. Ask for an itemized bill, so that everything you paid is broken down into individual items. This way you know the exact charge per item.

Next, call your insurance agency. One of the most common issues with insurance companies is that they enter the wrong code for the care you were provided, causing you to receive the wrong charges. Make sure to know exactly what your insurance covers, and how much. Even if you were rejected coverage, it can be met with an appeal.

Negotiate

Think of the medical bill you received as an initial offer. If the full bill won’t be covered by your insurance, try negotiating the fees down until an agreement is reached.

If you don’t have insurance or your insurance won’t cover the costs of your care, you may be able to receive a discount if you pay in cash. Often, healthcare providers will reduce their charges if a patient pays upfront and in cash. See if you can negotiate this kind of deal with your medical provider.

Shopping around to see what other hospitals charge for certain procedures can also be beneficial. Contact other medical providers to research and find out if their charges are in line with what you’re seeing on your medical bill. Use any information that you find, as well as Medicare rates, as a guide when disputing a bill.

Get Help

If you have collected all of your information and made dozens of calls but still have the same amount due, don’t get discouraged. When you need further assistance with your medical charges, many hospitals offer patient advocates. These are individuals who help you navigate the care you are provided. They can also help you understand your medical bills. You can find patient advocates online or directly through your medical provider.

It’s important to note that advocates don’t work for free — they work on contingency. Advocates take a percentage of the money you receive back after disputing your bill. In some cases, advocates charge an hourly fee.

Medical care is expensive. If you feel you were charged incorrectly or unfairly, it’s okay to dispute that charge. To expedite the process and improve your chances of getting money back, follow the steps outlined in this article.


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This post was updated December 3, 2019. It was originally published December 3, 2019.