You got an ER bill
Emergency care is the one thing you cannot shop for, which is exactly why these bills run high and why so many of them are wrong. Almost every ER bill has room in it.
Ask for the itemized bill
The summary statement you received is not the bill. Request the itemized version with every CPT code and charge listed. You cannot find an error on a document that says "Emergency Services: $8,400".
Do not pay anything yet
A payment can be read as agreeing the amount is correct. It also makes a refund much harder to claw back later. Nothing bad happens in the first few weeks.
Check whether the facility fee and the physician fee are separate
ER visits usually generate at least two bills, one from the hospital and one from the doctor who saw you. Getting one does not mean the other is not coming.
Look up the level code
ER visits are billed at levels 1 through 5. Level 5 is reserved for genuine life-threatening complexity. Upcoding a level 3 visit to a level 5 is the single most common ER billing error.
Guides for this situation
Your ER Bill Is Too High. Here's Exactly What to Do.
Emergency room bills are the most common source of medical bill shock, and the most likely to contain errors. Here's a step-by-step guide to challenging a high ER bill.
6 min read
Surprise Medical Bill? What to Do in 48 Hours
Got a surprise medical bill? Don't pay yet. Here's a step-by-step 48-hour action plan to verify the charges, request the itemized bill, and protect yourself before you pay.
6 min read
How to Request an Itemized Medical Bill (Step-by-Step + Script)
You have the right to an itemized medical bill that lists every charge by code. Here's exactly how to request one, what to say, and how to use it to catch overcharges before you pay.
7 min read
How to Read a Medical Bill: Every Section Explained
Medical bills are designed to be confusing. Here's a plain-English breakdown of every section, from the account number to the adjustment column, so you know exactly what you're looking at.
6 min read
Got an Out-of-Network Bill? Here's Exactly What to Do
Receiving an out-of-network bill doesn't mean you have to pay the full amount. Here's how to check your legal protections, dispute the charge with your insurer, and negotiate what you actually owe.
6 min read
What Is Balance Billing? When It's Legal and How to Fight It
Balance billing is when a provider bills you for the gap between their charge and what your insurer paid. Here's when it's legal, when it's banned under the No Surprises Act, and how to fight a balance bill you shouldn't owe.
7 min read
How to Catch Overcharges on a Medical Bill (Step-by-Step)
Up to 80% of medical bills contain an error. Here's a step-by-step audit to catch overcharges on your bill, the documents to request, the red flags to scan for, how to benchmark prices, and how to dispute what you find.
8 min read
How to Negotiate a Hospital Bill: Complete Guide
A practical guide to negotiating your hospital bill, including a phone script you can use today and a 5-step checklist to catch overcharges before you pay.
7 min read
Hospital Bill Negotiation Scripts: What to Say, Word for Word
Nine word-for-word phone scripts to lower a hospital bill: the itemized bill request, self-pay and prompt-pay discounts, charity care, settlements, payment plans, insurance disputes, and collections, plus the phrases to avoid.
9 min read
Itemized Bill vs. EOB: What's the Difference?
Two documents. One receipt, one referee's report. Understanding the difference between your itemized bill and your EOB could save you hundreds, or thousands.
5 min read
How PPO and HMO Rules Affect Unexpected Medical Bills
Your plan type decides how an unexpected bill reaches you. HMO denials come from missed referrals and prior authorizations; PPO bills come from out-of-network providers inside in-network hospitals. Here is how each one goes wrong, and what to do when it does.
9 min read
Can an ER bill be negotiated?
Yes. Emergency bills are negotiated routinely, both down to a corrected amount when there is a coding error and down to a settlement amount when there is not. Hospitals expect it.
What if I went to the ER without insurance?
You have more leverage, not less. Paying without insurance means you can ask for the cash price, which is often far below the billed charge, and apply for the hospital's financial assistance policy regardless of whether anyone offered it.
How long do I have before this hurts me?
Most bills move toward collections somewhere between 90 and 180 days after the first statement. Nonprofit hospitals have to wait at least 120 days before taking extraordinary collection action. You have more time than the letters suggest.
Rather not do this yourself?
Send us the bill and our investigator works the case for you: the itemized request, the line-by-line audit, and the calls with the billing office.
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