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No Surprises Act · HIPAA · State billing law

Medical Bill Dispute Letter

Studies show up to 80% of medical bills contain errors. The No Surprises Act and HIPAA give you powerful rights to dispute incorrect charges — hospitals and providers must respond in writing within 30 days.

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Common medical billing errors

Balance billing after insurance paid
Charging you the difference after insurer payment on in-network care
Services you didn't receive
Charges for procedures, tests, or medications not actually provided
Duplicate charges
Same service billed twice under different codes
Upcoding
Billing for a more expensive procedure than what was performed
Unbundling
Splitting a single procedure into multiple codes to increase charges
Wrong insurance processing
Claim sent to wrong insurer or not submitted at all

Federal laws that protect you

No Surprises Act (42 U.S.C. § 300gg-111)

Effective January 2022, this federal law protects patients from surprise bills when receiving emergency care or care from out-of-network providers at in-network facilities. If your insurer is involved, you cannot be charged more than your in-network cost-sharing amount.

HIPAA Privacy Rule (45 CFR § 164.524)

You have the right to request a complete itemized statement of all services billed. Providers must respond within 30 days. An itemized bill often reveals billing codes that don't match services actually received.

State balance billing laws

Many states have additional protections beyond federal law. NC Gen. Stat. § 131E governs hospital accountability in North Carolina. FL § 627.64194 protects against balance billing in Florida. Your letter cites the law that applies to your state.

What your letter demands

✓Complete itemized statement of all services billed with CPT codes
✓Written confirmation that the disputed charge has been removed or corrected
✓Immediate cessation of all collection activity during the dispute
✓Documentation of how the insurer's payment was applied
✓Response within 30 days — with named escalation to CFPB, state AG, and CMS if they fail

Disputing a medical bill?

Answer a few questions about your situation. Get a letter that cites the exact law that applies to your state and sets a 30-day deadline for the provider to respond.

✦ Write my dispute letter — $4.99
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