Your bill came in above the estimate
This is the most useful right almost nobody knows they have. If you were given a good faith estimate and the final bill from that provider came in $400 or more above it, you can force a review.
Find your good faith estimate
It may have been called an estimate, a cost breakdown, or nothing at all. If you paid without insurance or chose not to use it, the provider was required to give you one.
Compare per provider, not in total
The $400 threshold is measured against each individual provider's estimate, not the sum of everything. A bill that looks close in aggregate can easily clear the threshold on one line.
Watch the 120 day clock
You have 120 days from the date of the bill to start the dispute. It costs $25. Collections activity on the disputed amount freezes while it runs.
Note anything billed that was not estimated at all
This is the part that gets buried. If an item never appeared on the estimate and the provider cannot document that it was unforeseeable, it can resolve at nothing.
Guides for this situation
Hospital Bill Higher Than the Estimate? How to Dispute It for $25
If a provider's final bill came in $400 or more above their good faith estimate, a federal process lets you dispute it for $25. Collections freeze while it runs, and charges they can't justify fall back to the estimate. Here's how to file, step by step.
8 min read
What Is a Good Faith Estimate? Your Rights Before You Get Care
If you're uninsured or paying out of pocket, providers must give you a good faith estimate of your costs upfront, and if the bill comes in $400+ higher, you can dispute it. Here's how it works.
7 min read
How to Look Up What a Hospital Charges: The Price File Guide
Every US hospital is legally required to publish what it charges, including the cash price and the rate each insurer pays. Here is how to find that file in about two minutes, read it, and use the number to cut your bill.
8 min read
No Surprises Act Explained: Coverage & Rights
The No Surprises Act protects patients from unexpected out-of-network bills in many situations. Here's exactly what it covers, what it doesn't, and how to invoke your rights.
6 min read
How to Get a Self-Pay Discount on a Medical Bill
If you're uninsured or paying out of pocket, you can often cut a medical bill by 30-60% just by asking for the self-pay or prompt-pay rate. Here's exactly how to do it, with a phone script.
7 min read
How to Dispute a Medical Bill with Your Insurance Company
When your insurance denies a claim or pays less than expected, you have the right to appeal. Here's exactly how to dispute a medical bill through your insurer, and win.
7 min read
How to Read Your EOB: Complete Breakdown
An Explanation of Benefits is the most important document in medical billing, and most people ignore it. Here's a plain-English guide to every section of your EOB and how to use it to catch errors and reduce what you owe.
6 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
Who can use this dispute process?
People paying without insurance, and people who had insurance but chose not to use it for that care. Both count as self-pay and both are entitled to a good faith estimate.
What does it cost and how long does it take?
The fee is $25. The provider has 10 business days to respond and the reviewer has 30 days to decide.
What if I was never given an estimate?
That is itself a failure to comply, and it is worth raising directly with the provider's billing office before anything else. The requirement is not optional.
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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