A summary bill with one number tells you nothing. The itemized bill - every charge with its code and date - is where errors show up.
Get it
Ask the billing office in writing for an itemized statement with CPT/HCPCS codes, revenue codes, dates of service and units. Also get your insurer's Explanation of Benefits (EOB) for the same dates.
What to look for
- Duplicates - the same code twice on the same day without a reason.
- Services you didn't get - a test that was cancelled, medication you refused.
- Upcoding - a higher-level code than the visit justified (e.g. a level-5 ER visit for a minor issue). ER visits are coded 99281-99285 by complexity.
- Unbundling - separate charges for parts of a procedure that should be billed together.
- Wrong dates - charges after your discharge, or room charges for the discharge day.
- Wrong units - 10 units of a drug instead of 1.
- Out-of-network charges for providers you didn't choose (see the No Surprises Act).
- Already paid - insurer payments or your copay not credited.
Dispute it
Write to the billing office listing each disputed line - code, date, amount and why it's wrong - and ask for a corrected bill and a hold on the account while they review. Keep copies and note every call (date, name, what was said).
Then negotiate what's left
Even a correct bill is often negotiable: ask for the self-pay or prompt-pay discount, check financial assistance, and ask for a 0% payment plan.