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Why medical bills are so high

Medical billing in the US is notoriously opaque. Hospitals use complex pricing systems, and the same procedure can cost vastly different amounts depending on who is paying and how.

The good news is that medical bills are often negotiable. Hospitals regularly accept less than the full amount, especially from patients who ask.

Step 1: Get the itemized bill

Your first step is always to request an itemized bill with CPT codes. The summary bill hospitals send does not show you what you are actually being charged for.

• Call the billing department and request a detailed itemized statement.
• Ask for CPT codes (procedure codes) and ICD-10 codes (diagnosis codes).
• Review each line item for accuracy and duplicate charges.

Step 2: Audit for billing errors

Studies show that up to 80% of medical bills contain errors. Common mistakes include duplicate charges, upcoding, unbundling, and charges for services you did not receive.

• Duplicate charges: Same CPT code billed twice.
• Upcoding: Charged for a more expensive procedure than performed.
• Unbundling: Separate charges for items that should be bundled.
• Wrong patient info: Verify your insurance was applied correctly.

Step 3: Apply for financial assistance

Nonprofit hospitals are required to offer charity care programs. Even if you have insurance, you may qualify for significant discounts based on your income.

Income thresholds typically range from 100% to 400% of the Federal Poverty Level (FPL). A family of four earning under $124,800 may qualify for some level of assistance.

Step 4: Negotiate or appeal

If you do not qualify for charity care, you can still negotiate. Hospitals often accept 40-70% of the bill for cash payment. Use our scripts to negotiate effectively.

If insurance denied your claim, you have the right to appeal. We provide appeal letter templates with medical necessity language.