A medical bill you receive from a hospital or provider is not the same as the Explanation of Benefits (EOB) your insurer sends. The EOB is the source of truth — it shows what was billed, what the insurer paid, and what you actually owe after adjustments. Always cross-check the two before paying.

Ask the billing office for an itemized statement listing each service with its CPT (procedure) or HCPCS (supply) code. Federal law protects your right to receive this information at no cost.

Studies from the Medical Billing Advocates of America and Consumer Reports have found that 30–80% of hospital bills contain errors. The most frequent:

• Duplicate charges for the same procedure or supply
• Incorrect procedure (CPT) or diagnosis (ICD-10) codes
• Charges for services never rendered
• Upcoding — billing a more expensive procedure than performed
• Unbundling — separately billing services that should be one code
• Out-of-network charges at in-network facilities (No Surprises Act violation)
• Balance billing for emergency care above in-network cost-sharing
• Charges applied before deductible/EOB reconciliation

Under IRS Section 501(r), every nonprofit hospital in the United States must publish and follow a written Financial Assistance Policy (FAP). Most policies waive or steeply discount bills for households under 200–400% of the Federal Poverty Level — and many cover insured patients whose out-of-pocket costs exceed a threshold.

Request the FAP by name. Hospitals sometimes steer patients toward payment plans instead; those are not the same as charity care. Applications are typically accepted for at least 240 days after the first bill, and often even after collections have begun.

The federal No Surprises Act protects patients from most out-of-network balance billing in three situations:

• Emergency services at any facility
• Non-emergency services at in-network facilities delivered by out-of-network providers (anesthesiologists, radiologists, pathologists, assistant surgeons)
• Air ambulance services

In these cases, you can only be charged your in-network cost-sharing amount. If you receive a bill that appears to violate these protections, file a complaint at cms.gov/nosurprises or call 1-800-985-3059.

Under the Affordable Care Act, you have the right to two levels of appeal for most denied claims:

1. Internal appeal — filed with your insurer, typically within 180 days of the denial. Cite the specific plan language and attach a letter of medical necessity from the treating provider.
2. External review — an independent third party reviews the denial. Their decision is binding on the insurer.

For urgent care, expedited appeals must be decided within 72 hours. Keep every letter, EOB, and phone log — dates and names matter.

Use our free appeal letter builder →

You never need to pay a for-profit "medical bill negotiator." The following organizations provide the same help at no cost:

• SHIP / SHIBA / HICAP

  Free state health-insurance counselors funded by the federal Administration for Community Living. Available in every state and territory.

• Dollar For

  National nonprofit that helps patients apply for hospital charity care. Free service, no income cutoff.

• PAN Foundation

  Copay assistance for patients with chronic conditions.

• HealthWell Foundation

  Grants for underinsured patients to cover copays, deductibles, premiums.

• NeedyMeds

  Directory of patient assistance programs for medications and treatment.

• RIP Medical Debt (Undue Medical Debt)

  Nonprofit that buys and abolishes qualifying medical debt.

• Legal aid — Find local help

  Free legal assistance for low-income patients facing collections or coverage disputes.

• 211 Community Resource Directory

  Nationwide directory of local financial and healthcare assistance programs.

1. 1

   Request an itemized bill

   Call the billing department and ask for a line-item bill with CPT/HCPCS codes. You are legally entitled to this.

2. 2

   Compare to your EOB

   Match every charge on the bill to the Explanation of Benefits from your insurer. Flag anything that does not appear.

3. 3

   Verify network status

   Confirm each provider and facility was in-network on the date of service. Screenshot the insurer's directory as evidence.

4. 4

   Apply for financial assistance

   If the facility is a nonprofit hospital, request the Financial Assistance Policy in writing. Submit an application even if you have insurance.

5. 5

   Negotiate or appeal in writing

   For denied claims, file an internal appeal within the deadline (usually 180 days). For self-pay balances, request the self-pay or prompt-pay discount.

6. 6

   Escalate if needed

   Contact your state Insurance Commissioner, SHIP counselor, or a legal aid attorney. File a No Surprises Act complaint at cms.gov/nosurprises.

This hub relies exclusively on federal agencies and established nonprofits. Every claim above links back to one of these sources.

• IRS Section 501(r) — Financial Assistance Policy requirements for nonprofit hospitals
• CMS — No Surprises Act guidance for patients
• HealthCare.gov — Appealing a health plan decision
• CFPB — Medical debt and your credit report
• SHIP National Technical Assistance Center
• Dollar For — Charity care advocacy nonprofit