How to dispute a medical bill

Good faith estimate vs. a bill dispute

A good faith estimate is the written price list an uninsured or self-pay patient gets before scheduled care; the patient-provider dispute process is what you can use when the bill comes in at least $400 higher than that estimate. Both come from the No Surprises Act. Providers must give the estimate within one business day when care is scheduled 3–9 business days ahead, within three business days when it is scheduled 10 or more business days ahead, and within three business days when you ask for one; care scheduled 0–2 business days ahead carries no estimate right.^[4][3] See how good faith estimates work.

Dispute a medical bill: who qualifies, cost and deadline

You can start a dispute if you did not have or did not use insurance, told the provider so, got a good faith estimate, received care on or after January 1, 2022, and one provider or facility billed at least $400 over its own estimate, with the first bill dated within the last 120 calendar days.^[1] The $400 test is per provider or facility, so compare each estimate with that provider's bill, not the total of all bills.^[2] The fee is $25, non-refundable; if the decision goes your way it is taken off what you owe. You file online or by mail with copies, not originals, of the estimate and the bill.^[1]

Worked example. An estimate of $2,000 and a bill of $2,650 dated September 1, 2026 is $650 over, so it qualifies, and the last day to file is December 30, 2026. A bill of $2,300 on the same estimate is only $300 over and does not.

• Your bill cannot go up because you disputed it, and while the dispute is open the provider cannot send the bill to collections, threaten to, or collect late fees; a bill already in collections must be paused.^[1]
• The reviewer can leave the bill as it is if the extra charges were for care the provider could not reasonably have foreseen, or reduce it if they should have been in the estimate.^[1]

Itemized hospital bill and posted prices

An itemized hospital bill lists every charge with its code, units and price, and it is what you compare with the estimate and with the hospital's posted prices. Every hospital must post a free machine-readable file of its standard charges, including a discounted cash price for self-pay patients, and a consumer-friendly list or price estimator for at least 300 shoppable services; where there is no cash price, the gross charge must be shown.^[5] Find the file through the "price transparency" link on the hospital's website and look up each code on your bill. For typical self-pay prices, see ER visit cost, MRI cost and how to negotiate medical bills.

Financial assistance and payment plans

Nonprofit hospitals must have a written financial assistance policy, publish it with the application and a plain-language summary, and charge eligible patients no more than the amounts generally billed to insured patients for emergency and medically necessary care.^[6][7] You can apply until at least 240 days after the first post-discharge bill, and the hospital must wait 120 days from that bill, with written notice at least 30 days ahead, before extraordinary collection actions.^[8][9] These rules bind tax-exempt hospitals only. More detail: hospital charity care.

If you will pay over time, compare an interest-free plan from the hospital with financing. Medical credit cards often carry deferred interest: if the balance is not cleared by the end of the promotion, interest is charged back to the purchase date; the CFPB found the typical medical card APR was 26.99%.^[10] See the payment plan calculator.