QuestionTheBill

Got a bill? Here’s what to do.

Eight steps, in order. Each one links to the official page it comes from. This is general information, not legal advice.

  1. Ask for an itemized bill before you pay

    Ask the billing office for a list of the cost of each item and service. You should not be billed for anything that is not in your medical records.

    • Compare it with your insurer’s Explanation of Benefits. The “your share” amount should match what the provider bills you.
    • Look for duplicate charges, which are common when several providers were involved.
    • Look up the billing codes and confirm they match the care you received.
    • Check that the bill is really yours and has not already been paid.

  2. Know your protection from surprise bills

    Since January 1, 2022, the No Surprises Act protects people with insurance from unexpected out-of-network bills for emergency room visits, for non-emergency care at an in-network hospital or surgery center, and for air ambulance services.

    Ground ambulance rides are not covered by this protection.

    Help deskThe federal No Surprises Help Desk is 1-800-985-3059, weekdays 8 am to 8 pm and weekends 10 am to 6 pm Eastern. It can answer questions and help you file a complaint. File a complaint with CMS

  3. No insurance, or paying yourself? Use your good faith estimate

    If you do not have insurance or choose not to use it, providers usually must give you a good faith estimate when you schedule care at least three business days ahead, or when you ask for one.

    • If the bill is $400 or more above the estimate, you can dispute it.
    • The first bill must be dated within the last 120 calendar days.
    • The fee is $25. If you win, it is taken off what you owe.
    • The provider cannot send the bill to collections while the dispute is open.

  4. Ask the hospital about financial assistance

    Nonprofit hospitals must have a written financial assistance policy, publish it on their website, and give you a free copy and a plain-language summary if you ask. This is often called charity care.

    • If you qualify, the hospital cannot charge you more than the amounts it generally bills insured patients for emergency or medically necessary care.
    • The hospital must wait at least 120 days after your first bill before taking steps such as selling the debt, reporting it to credit bureaus, or garnishing wages. You have 240 days from the first bill to apply.
    • Ask for the policy early, expect to show income documents, and tell any collector that you have applied. Some states and some for-profit hospitals have their own programs.

  5. Dispute what is wrong, in writing

    If you disagree with a charge, you have a right to an appeal with your insurer and an outside review.

    • If the bill goes to a debt collector, the collector must send you a validation notice in its first contact or within five days.
    • You have 30 days to dispute the debt in writing. If you do, the collector must pause collecting the disputed amount until it answers.
    • Send copies, never originals, and keep a record of everything.

  6. Negotiate, and ask for a payment plan

    You can ask to pay an amount you can afford, and you can ask for a payment plan with no interest. Always ask about financial assistance first.

    Be careful with medical credit cards. They are often more expensive than other ways to pay, with rates that can pass 25 percent, and with deferred interest a late payment can add interest on the full amount.

  7. Know how medical debt can reach your credit report

    A federal rule issued on January 7, 2025 would have kept medical debt off credit reports. A federal court set it aside on July 11, 2025, and it is not in effect.

    The Consumer Financial Protection Bureau says unpaid medical debt that is more than 365 days past due and over $500 could appear on your credit reports. You can check your reports for free and dispute errors.

  8. Get free help

    • Many states run Consumer Assistance Programs that help with coverage and billing problems. If yours does not, try your state insurance department.
    • If you have Medicare, your State Health Insurance Assistance Program offers free local counseling.
    • Hospitals must post their prices online. If a hospital has not, you can report it to CMS.
    • You can send a complaint about a collector or lender to the Consumer Financial Protection Bureau at (855) 411-2372.

This page is general information to help you ask good questions. It is not legal advice, and rules can differ by state and by plan.