Negotiate a bill
Medical bills are negotiable in ways most people are never told about, and several of the levers are federal rules rather than goodwill. Every template here quotes the rule it rests on — the No Surprises Act, IRS section 501(r) for nonprofit hospitals, the Fair Debt Collection Practices Act, the hospital price transparency rule — and every draft stays in your browser.
Open the letter generator →Start here, in this order
1. Check your bill for errors
An interactive checklist over an itemized statement — duplicates, unbundling, quantities, canceled services, dates you were not there.
2. Is this an overcharge?
Compare what you were billed against typical cash prices and get a factual multiple — "3.2× the typical cash price" — that a letter can quote.
3. Charity care screener
Six questions to see where you fall against the federal poverty guidelines, and whether the hospital is a nonprofit with a required assistance policy.
4. Track one bill
A timeline for a single bill: letter sent, response due, next action — with calendar reminders. Stored in your browser only.
The seven letters
Each has its own guide explaining when it applies, what it rests on, and what to do after sending.
- Request an itemized billThe first letter to send about any medical bill. A summary bill hides what you were actually charged for; an itemized bill lists every line with its billing code, which is the only version you can check for duplicates, unbundling, or services you never received.
- Dispute a billing errorFor when the itemized bill shows something wrong: a duplicate charge, a quantity that does not match the care you received, a service on a date you were not there, or an unbundled item billed separately. Names each disputed line and asks for a corrected statement.
- Billed above the cash priceFor when your bill is well above what the same provider charges cash-paying patients, or above typical prices in your area. Cites the hospital price transparency rule requiring hospitals to publish their discounted cash prices, and asks for that rate.
- Apply for financial assistanceFor nonprofit hospital bills you genuinely cannot pay. Federal rules require every 501(c)(3) hospital facility to maintain a written financial assistance policy covering emergency and medically necessary care. This letter formally requests that policy and applies under it.
- Dispute a surprise out-of-network billFor balance bills after emergency care, or after treatment at an in-network facility by an out-of-network clinician you did not choose. The No Surprises Act limits what you can be billed in exactly these situations — this letter names it and asks for the bill to be corrected.
- Bill exceeds your Good Faith EstimateIf you were uninsured or self-pay, received a Good Faith Estimate, and the bill came in at least $400 above it, you can start the federal patient-provider dispute resolution process. The window is 120 calendar days from the date of the first bill, and the fee is $25.
- Demand validation from a debt collectorFor a debt collector's first contact. Disputing in writing within 30 days of their validation notice requires the collector to pause collection of the disputed amount until they verify the debt. This letter makes that request precisely and asks them to communicate in writing.
Everything you type here is computed in your browser. Nothing you enter is stored on a server, sent anywhere, or shared — there is no account, and your balances never leave your device.
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Frequently asked questions
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