# 13 · US medical bill: find errors and request a review

**Use after template 12,** once you have the itemized bill (and the EOB if insured).

## Step 1 · Have AI review it (10 minutes)

Paste this into Claude or ChatGPT together with the itemized bill text (remove your Social Security number, insurance member ID and address first):

```
You are a careful US medical billing reviewer. Below is an itemized hospital/provider bill [and my insurer's Explanation of Benefits]. Review it line by line and produce a table: line, date, code, description, charge, and an "issue" column.

Flag:
1. Exact or near duplicates (same code, same date, same units), including services billed both as a bundled/"master" charge and as separate lines.
2. Unbundling: components billed separately that are normally included in one procedure or room/facility charge.
3. Wrong place of service or status (e.g., inpatient vs. observation vs. emergency) and whether the level billed matches the visit described.
4. Charges for dates that don't match my stay (e.g., billed for the day of discharge or before admission), or quantities that look impossible (e.g., 24 hours of a service in a 4-hour visit).
5. Services I may not have received (I will confirm): list them as questions.
6. Charges that differ from the EOB "allowed amount" or that the EOB marks as "patient not responsible".
7. Supplies and medications that look like they should be included in the room or procedure charge.

Do not invent rules. When you're unsure, say "verify with the provider". Then draft a polite, firm letter to the billing department listing each disputed line with a one-sentence reason and asking for a corrected bill. Keep it under one page.

Facts: patient [NAME], dates [DATES], what actually happened: [ONE-PARAGRAPH TIMELINE: arrival time, what was done, discharge or death time].

BILL:
[PASTE ITEMIZED BILL]
```

Check every flag yourself against your records. The AI points; you confirm.

---

## Step 2 · Dispute letter

> [YOUR NAME] · [ADDRESS] · [PHONE] · [EMAIL]
> Patient: [NAME], DOB [DOB] · Account [NUMBER] · Dates of service [DATES]
>
> [PROVIDER] · Billing Department · [ADDRESS]
> [DATE]
>
> **Re: Request for billing review and corrected statement · account [NUMBER]**
>
> Hello,
>
> I have reviewed the itemized statement dated [DATE] and believe it contains the following errors:
>
> | Line | Date | Code | Charge | Issue |
> |---|---|---|---|---|
> | [ ] | [ ] | [ ] | [ ] | [e.g., duplicate of line X: same code, same date] |
> | [ ] | [ ] | [ ] | [ ] | [e.g., billed as inpatient; patient was seen in the ER for 4 hours and never admitted] |
> | [ ] | [ ] | [ ] | [ ] | [e.g., ventilator charge on a date before it was used] |
>
> Please review these items, correct the account, and send me a revised itemized statement. [IF INSURED: Please also resubmit the corrected claim to my insurer, [INSURER], member ID available on request.]
>
> Please keep the account on hold from collections while this review is pending. I am happy to pay the correct amount.
>
> [IF UNINSURED: I also request a self-pay discount and an application for financial assistance under your financial assistance policy.]
>
> Sincerely,
> [NAME]

## Step 3 · Negotiate what's left
Once the errors are removed:
- "What's the self-pay / prompt-pay discount if I pay in full this month?"
- "Can you reduce the balance to what Medicare / my insurer would pay for these codes?"
- "Can I have an interest-free payment plan of [AMOUNT] per month?"
- Get any agreement **in writing before you pay**.

## Step 4 · Escalate if needed
- Insurer denied or underpaid: file an internal appeal with your insurer (deadline on the EOB), then an external review.
- Surprise billing / Good Faith Estimate issues: cms.gov/nosurprises (has a help desk and complaint form).
- Hospital ignores you: your state attorney general's consumer protection office or state health department.

> This is a template, not legal or medical advice. For very large bills, a patient advocate or medical-billing advocate can help; some work for a percentage of savings, so ask about fees first.