Medical bill dispute letter 2023 (guide + free example)

This post covers a medical bill dispute letter.

Can you imagine where you expected a $104 bill but received over $1,000 bill for your medical treatment?

Very frustrating!

Look!

According to Pat Palmer, CEO, and founder of Medical Billing Advocates of America, his organization finds errors on three out of four medical bills they review.

Further according to the most recent data available, 80% of medical bills in the United States contain errors. (source).

Again the average hospital bill over $10,000 has $1,300 in error (source).

That data shows that errors in medical bills are a huge and common problem.

Now! how do you dispute errors in your medical bill?

It is through a strong medical bill dispute letter.

Writting a strong medical bill dispute letter is hard, especially if it is your first time. You really need a guide on what to say and how to say it.

To help you get started, here I will guide you on;

  • What is a medical bill dispute letter
  • Why do you need a medical bill dispute letter
  • Things to consider before writing your medical bill dispute letter
  • How to write an effective medical bill dispute letter
  • Medical bill dispute letter template
  • Medical bill dispute letter example
  • What if your medical bill dispute letter did not work? (plan B)
  • etc.

Let’s get started

Related: Medical clearance letter (guide + free samples)

What is a medical bill dispute letter?

A medical bill dispute letter is a brief statement of facts written by a person to dispute the errors contained in his/her medical bill.

This letter informs the billing provider about the mistakes in the bill and requests they fix the mistakes.

A medical bill dispute letter can be used to dispute different bill errors including;

  • typos
  • duplicate charges
  • charges for canceled procedures
  • Code error – this can lead to the billing of the wrong service or product
  • etc.

Why do you need a medical bill dispute letter?

Generally, you need a strong medical bill dispute letter to report the errors in your medical bill and request the billing provider to fix those errors accordingly.

Also;

  • It is the quickest way to resolve medical bills honest mistakes
  • It is a simple, cheap, and efficient mechanism to handle bill errors
  • If the issues go further, your dispute letter will act as evidence that you reported the error.
  • etc.

Things to consider before writing your medical bill dispute letter

The following are the important things to consider before writing your wing medical bill dispute letter.

Ascertain the errors

This is the first thing to consider before writing your dispute letter.

Asserting the error will help you justify it.

There are two ways that I have found work great when it comes to ascertaining the billing error

One is to compare your explanation of benefits to your actual medical bill and the second is to review your billing code.

Here is how they work.

By comparing the explanation of benefits received from your insurance company you will be able to spot the charges difference to your medical bill.

For example, when comparing his explanation of benefits to his medical bill, Robert Farrington was able to detect that the Explanation of Benefits was $24 short of what they billed him.

After closer inspection, he also noticed that they combined two Explanation of Benefits into one bill and the medical provider billed his insurance company two separate times, but only billed him once.

When Mr. Farrington reviews his billing code, he also discovered he was billed for the wrong procedure.

He was billed for Ulna Surgery when he didn’t have surgery, but just an examination.

He noticed a 1 digit error in the code which resulted in a 10x medical bill.

NB: To review your bill, you have to search online for the billing code listed on your detailed bill.

Therefore I advise you to do your homework just like Mr. Farrigton did.

This will help you spot the errors clearly and come up with a strong dispute letter.

If you have found Mr. Farrington’s issue interesting, you may read it here

Organize your documentation

In order to write the winning medical bill dispute letter, you need to support it with documentation that proves the errors of your healthcare provider.

Make sure you have;

  1. An itemized statement of your medical bill
  2. explanation of benefits
  3. Diagnosis documentation
  4. Treatment and Doctor’s prescriptions documents
  5. etc.

How to write a medical bill dispute letter

A medical bill dispute letter is written in a business letter format. Begin your letter with your address and contact information, followed by a date and the medical provider’s address, and state that you are writing to report the medical bill error, providing the details of the error and asking them to fix it accordingly.

Finish your letter with SINCERELY followed by your name and signature.

REMEMBER the aim of your medical bill dispute letter is to inform the medical provider about the error contained in your medical bill and ask them to fix it

The following is how you can write a strong winning medical bill dispute letter

  • Provide your name, address, and contact information
  • Include the date of the letter
  • Include the recipient’s name, address, and contact information
  • Provide your billing account number
  • Provide the date of the bill
  • State the total amount charged
  • Explain why you think it improper to charge that amount
  • State the amount you think is reasonable and give reasons
  • Explain what you want the medical provider to do in response to your letter
  • Be concise and to the point
  • Maintain a professional tone
  • Be honest

Medical bill dispute letter template

Your Name
Address
City, State, Zip Code
phone
email

DATE

[Billing Department]
[Recipient’s organization]
[Recipient’s Street Address]
[Recipient’s City, State, and Zip Code]

Dear [Recipient’s last name]

Please be notified that I’m disputing [$#] charge on my medical bill dated [date] due to the following reasons

  1. Reason one
  2. Reason two
  3. Reason three
  4. etc.

I find [$#] to be a reasonable charge since [explain why do you think you deserve that charge].

I have attached to this letter the following documentation to support my claim

  1. Document 1
  2. Document 2
  3. etc

Kindly I request you to [Explain what you want the medical provider to do in response to your letter] within [#] days upon receipt of this letter.

Thank you for your consideration and understanding regarding this letter.

I hope to hear from you as soon as possible upon receiving this letter. Please contact me at [phone] or at [email].

Sincerely, 

signature

Name

Billing No. [#]

Medical bill dispute letter example

Jane Henry
101, Dean Drive
Avic Town, CA,10120
555-078-4536
henryjane@email.com

January 30, 20…

Billing Department
ABC Hospital
2001 Health Avenue
Medical City, CA, 10124

To whom it may concern

Please be notified that I am disputing a $1002 charge on my medical bill No. 533-469-567 dated January 18, 20… for the following reason.

  1. After reviewing my billing code carefully, I have discovered that I was charged $500 for Electrocardiogram and some blood tests which I did not take.

I find $502 to be a reasonable charge since I was admitted to your hospital as a result of an unfortunate accident where I unintentionally bent my knee and according to your itemized statement of my medical bill the cost to fix my injury when I exclude the test that I did not take is $502.

I have attached to this letter the following documentation to support my claim

  1. copy of the bill 
  2. An itemized statement of my medical bill
  3. copy of the result of my knee x-ray (the result sheet indicates a knee x-ray and not an ECG.)

I strongly believe that this is purely an honest mistake therefore I kindly request you issue a new bill wherein the ECG and blood tests are removed within 30 days from the date of receiving this letter.

Thank you for your consideration and understanding regarding this letter.

I hope to hear from you as soon as possible upon receiving this letter. Please contact me at 555-078-4536 or at henryjane@email.com.

Sincerely, 

signature

Jane Henry

Medical bill dispute letter pdf

What if your medical bill dispute letter did not work?

The following are the proper recourse to seek in case your medical bill dispute letter did not work.

When I say it did not work I mean, despite your letter, the medical provider refused to fix the bill errors.

Here is what you can do

  • File an appeal With your insurance company
  • File an appeal with your Medical Provider’s Patient Advocate
  • Contact your State Insurance Commissioner
  • Find an attorney that specializes in medical billing disputes for further actions (new to finding an attorney? I have this guide to help you choose the right one)
Isack Kimaro
Isack Kimaro

Editor-in-chief and founder of sherianajamii.com. Holder of Bachelor of Laws (LL.B) and Post Graduate Diploma in Legal Practice. Lawyer by profession and blogger by passion