What To Do When You Receive a Medical Bill

Do Not Pay Right Away

The instinct to pay a bill as soon as it arrives is understandable, but medical bills are different from most other bills. They frequently contain errors, and paying before verifying can mean overpaying for charges that are wrong, duplicated, or not your responsibility.

Step 1: Gather Your Documents

Before you do anything else, collect three documents: the medical bill, your Explanation of Benefits (EOB) from your insurance company, and your insurance card. Having all three in front of you gives you the full picture of what was billed, what insurance approved, and what you may owe.

Step 2: Compare the Bill to Your EOB

Line up every service on the bill against the corresponding line on your EOB. The patient responsibility on the EOB is the amount your plan calculated you owe. If the bill asks for more than that number, something is likely wrong.

Step 3: Look for Common Errors

Medical bills commonly contain errors. Watch for duplicate charges, services you did not receive, incorrect procedure codes, missing in-network adjustments, and charges for services that were denied by insurance rather than covered.

• Duplicate charges - the same service billed twice.
• Phantom charges - services you never received.
• Wrong codes - a procedure code that does not match the EOB.
• Missing adjustments - the in-network discount not applied.
• Uncovered services billed to you without a denial notice.

Step 4: Request an Itemized Bill

If the bill is a summary statement showing only a total, request an itemized bill. An itemized bill lists every service with its CPT code, description, and individual charge. Without this breakdown, you cannot verify accuracy.

Step 5: Take Action

If the bill is correct, pay it or set up a payment plan. If the bill contains errors, contact the provider billing department with your findings and request a corrected statement. If the provider does not resolve the issue, escalate to your insurer or state insurance commissioner.