Got a surprise medical bill? Draft the dispute that gets it reduced.
An itemized-bill dispute citing the No Surprises Act and hospital financial-assistance rules. Preview it free before you pay.
- I am writing regarding Account #847291-C, reflecting a balance
- of $14,720 for services rendered on March 10, 2026. I am
- requesting review under your financial assistance program and
- invoking my rights under the No Surprises Act (Public Law
- 116-260) regarding the out-of-network charge on line item 6.
- Per CMS Hospital Price Transparency rules (45 CFR 180), I
- request your standard charge data for CPT codes 99285 and
- 36415 as billed. The balance I received significantly exceeds
- the shoppable price listed on your price transparency tool...
Full letter includes: itemized dispute, applicable statute citations, charity care inquiry, settlement proposal, and response deadline request.
What's actually happening.
You got a bill that doesn't match what your insurance said you'd owe. Or it's huge and you can't pay it. Or it has charges you don't recognize.
You can negotiate. Most hospitals have charity care programs, financial assistance, and settlement policies, but they don't advertise them.
The right letter, citing the right rules, gets results. Most people never send one.
How it works.
Upload the notice, answer a few questions
A photo, a PDF, or the pasted text of what they sent you. Then the minimum we need: your name, what happened, any context.
Read the whole draft, free
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Pricing.
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The full letter as PDF and Word. You print it, sign it, and send it.
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Laws we cite.
Every letter is grounded in real statutes and regulations. These are the ones that apply here.
Pub. L. 116-260 No Surprises Act. Protects against balance billing by out-of-network providers in emergency and certain other situations.
45 CFR 180 CMS Hospital Price Transparency Rule. Requires hospitals to publish standard charges; we use it to challenge overbilling.
State charity care laws Most states require hospitals to offer financial assistance programs. We invoke the applicable state law.
ACA § 501(r) Nonprofit hospitals must maintain financial assistance policies under penalty of losing tax-exempt status.
Who this isn't for.
We are honest about our limits. FightThis may not be right if:
- The bill is from a physician's practice rather than a hospital facility. Physician billing has different leverage points.
- The bill is in collections and you're past the dispute window for the original provider.
- You need debt settlement negotiation rather than a billing dispute. That's a different service.
- The amount is under $200 and the time investment outweighs the savings.
If your situation is high-stakes, please find a local attorney. Many state bars have free or low-cost referral services.
Common questions.
Do I negotiate before or after insurance pays?
After. Once your insurance has paid its share (or if you're uninsured), you negotiate your out-of-pocket portion. Our letter identifies which scenario you're in and frames accordingly.
What is a surprise bill?
A surprise bill is when you receive out-of-network charges for emergency care, or from an out-of-network provider at an in-network facility, without prior notice. The No Surprises Act limits what you can legally be charged.
Can I dispute charges for services I did receive?
Yes. If the charges are inflated relative to standard rates, or if the itemized bill contains errors, you have the right to dispute. Our letter requests itemization and challenges specific discrepancies.
What if I simply can't pay?
Nonprofit hospitals receiving federal funding are required to have financial assistance (charity care) programs. We ask about your eligibility and request a formal review.
Will this hurt my credit?
Not if you act quickly. Medical debt under $500 was removed from credit reports in 2023. For larger amounts, a disputed account in active correspondence is less likely to be sent to collections.
What if they send it to collections while I'm disputing?
That's a violation of the Fair Debt Collection Practices Act if the debt is legitimately in dispute. Our follow-up FDCPA letter covers this scenario.
We mail it for you
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