A medical bill arrived. Start here.
Understand what the bill means, find the right person to call, check your rights, and take one step at a time. Every recommendation points to an official source or established nonprofit.
Walk through my billStart with the closest match. You do not need an account.
How to read a medical bill
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.
Common billing errors to watch for
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
Hospital charity care (Financial Assistance Policies)
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 No Surprises Act (2022)
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.
Appealing an insurance denial
Under the Affordable Care Act, you have the right to two levels of appeal for most denied claims:
- 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.
- 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.
Free help programs — nationwide
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.
Your 6-step medical bill plan
Check off each step as you go. Use the attached official help when you need it.
Turn an itemized bill into a plain-language list of charges.
Compare the insurer's decision with the provider bill.
Non-profit that checks whether your hospital bill qualifies for charity care and helps you apply.
Review common hospital assistance rules before you apply.
Create a clear written appeal from your records.
Federal help desk for surprise bills and balance billing complaints. Open 7 days a week.
Pick your state to file a complaint against a health plan or request an external review.
Did this help you understand what to do next?
Frequently asked questions
What should I do first when I receive a surprise medical bill?
Do not pay immediately. Request an itemized bill (line-item CPT/HCPCS codes), compare it against your Explanation of Benefits (EOB) from your insurer, and check for duplicate charges, incorrect codes, or services you did not receive. Under the federal No Surprises Act (2022), most out-of-network emergency charges and many ancillary services at in-network facilities must be billed at in-network rates.
Am I eligible for hospital charity care or financial assistance?
Every nonprofit hospital in the United States is required by IRS Section 501(r) to maintain a written Financial Assistance Policy (FAP). Most hospitals waive or reduce bills for households under 200–400% of the Federal Poverty Level. Ask specifically for the 'Financial Assistance Policy' — not a payment plan — and request an application in writing. You can apply even after the bill has gone to collections.
How do I appeal an insurance denial?
You have the right to two levels of appeal: an internal appeal with your insurer (typically 180 days from the denial notice) and an external review by an independent third party. Always request the denial reason in writing, cite the specific plan document language, and include a letter of medical necessity from your provider. Marketplace and most employer plans are covered by the ACA appeal rights.
Is medical debt still reported to credit bureaus?
As of 2023, the three major credit bureaus (Equifax, Experian, TransUnion) no longer report paid medical debt, medical debt under $500, or debt less than one year old. The CFPB has proposed a rule to remove all medical debt from consumer credit reports.
Can I negotiate a medical bill directly with the hospital?
Yes. Hospitals routinely accept 30–70% reductions for uninsured or self-pay patients, especially when offered a lump-sum payment. Ask for the 'self-pay rate,' the 'prompt-pay discount,' or a 'cash-pay negotiation.' Get any agreement in writing before paying.
What free help is available for confusing medical bills?
Every state runs a free federally-funded counseling program known as SHIP (State Health Insurance Assistance Program) — called SHIBA in Washington and HICAP in California. Legal aid organizations, community health advocates, and patient assistance foundations also help at no cost. See the Free Help section below for direct links.
Citations & primary sources
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
For organizations linking to this hub
We keep this page freely available for 211 directories, legal aid organizations, SHIP/SHIBA offices, hospital financial counselors, and patient-assistance nonprofits. Recommended link text:
<a href="https://themurraystandard.org/medical-billing-help">Medical Billing Help & Patient Assistance Hub</a>