How to check a hospital bill and ask for financial help

Small hospitals bill like big ones. Before you pay a hospital bill, ask about financial help, then check every line.

Physician Dr. Virgie Bright Ellington teaches a simple three-step method that I think every patient should know. Here it is in plain language.

Step 1: Ask for the itemized bill

Do not pay from the summary bill. Call the billing office and ask for an itemized bill that lists the billing code for each charge (CPT or HCPCS codes). Also ask what was sent to your insurance company and what it paid. Federal privacy law gives you the right to see and get a copy of your medical and billing records.

Step 2: Check every line

• Look up each code and make sure you actually received that service.
• Look for duplicates, items you never got and days you were not there.
• Compare the price to what Medicare pays for the same code. Medicare's fee schedule lookup is free and public. Dr. Virgie uses it as a yardstick for a fair price.
• Compare the bill to the Explanation of Benefits (EOB) from your insurer. They should match.

Step 3: Call back, ask for a fair amount and a payment plan

Call the billing office with what you found. Ask them to remove errors, ask for a fair price, and ask for an interest-free payment plan at a monthly amount you can actually afford. Write down the date, the name of the person you spoke with and what they agreed to.

Ask about financial assistance first

Nonprofit hospitals are required by federal tax rules to have a written financial assistance policy, often called charity care. Some for-profit hospitals offer help too. Ask for the application before you pay, then check the reduced bill with the three steps above.

Think twice about medical credit cards

Dr. Virgie advises against medical credit cards. You skip the bill review, the interest-free period can be short, and an unpaid balance can hurt your credit. A payment plan with the hospital or clinic is usually safer.

When to get help

If a bill is large, a denial seems wrong or you cannot make sense of it, a certified medical bill advocate can help. Dr. Virgie's company, Medical Bill Shield, works with employers on medical bill audits, and her site CrushMedicalDebt.com has free resources and her book.

This page is general education, not legal, financial or medical advice. In a medical emergency, call 911. Get care first and deal with the bill later.