If a hospital bill is more than you can pay, you don't have to work it out alone. Some of the best help is free and sits inside the hospital itself. Other help costs money but takes the whole thing off your plate. Here's who can help, what they charge, and the order to try them in.
Quick answer
Free help: the hospital's financial assistance program and financial counselors, your insurer, and nonprofits like Dollar For. Paid help: independent patient advocates and bill negotiation services such as mediloop, Resolve and Goodbill. Try the free routes first. mediloop charges $129 flat per bill and refunds the full $129 if the bill isn't lowered by at least that.
Who can help lower a hospital bill
A hospital bill usually comes down for one of four reasons: a mistake gets fixed, insurance pays what it should have, you qualify for financial assistance, or the hospital agrees to a discount. Different people can help with each of those.
Free help
The hospital's financial assistance program
Nonprofit hospitals, which is most hospitals in the US, have to have a written financial assistance policy. Depending on your income it can cut the bill a lot or wipe it out, and it often applies even if you have insurance. Ask for the policy and the application. Our charity care checker gives you a quick idea of whether you might qualify, and this guide walks through applying.
Hospital financial counselors and the billing office
Counselors help with assistance applications and payment plans. The billing office can fix a charge you point out and may offer a self-pay or prompt-pay discount. Remember they work for the hospital, so they won't go looking for problems on your behalf.
Your insurer
If a claim was denied or paid wrong, your insurer is the one that can fix it. You have the right to an internal appeal and, in many cases, an external review. See how to dispute a bill with insurance.
Nonprofits
Groups like Dollar For help people apply for hospital charity care for free. They're a good fit when financial assistance is the main way the bill will come down. Here's how mediloop and Dollar For compare.
Everything above is the general version. To see what applies to your own bill, upload it to a free mediloop account. An automatic first look reads the charges and shows what looks worth questioning, usually in about a minute. If you want a specialist to take it from there, it is a flat $129, refunded in full if the bill isn't lowered by at least $129.
Check my bill for freePaid services
Paid help makes sense when the bill is large or complicated, there's more than one provider, insurance is involved, or you've tried and got nowhere. There are two main kinds.
- Independent patient advocates. People you hire directly, often found through the APHA or PACB directories. They usually charge by the hour or take a share of the savings.
- Bill negotiation services. Companies such as mediloop, Resolve and Goodbill that review the bill and work it with the provider and insurer. Fees range from flat to a percentage of savings.
Some employers and health plans already include bill help as a benefit, so check with HR or member services before paying for one.
How the paid services charge
Fee models matter more than they look. On a $10,000 bill that drops by $4,000, a 25% fee is $1,000, while a flat fee stays the same whatever the result. Ask any service what you'd pay if the bill drops a little, a lot, or not at all. Our side-by-side of the best medical bill negotiation services lays out how each one charges.
What order to try them in
- Get the itemized bill and check it against your EOB.
- Ask about financial assistance and apply if you might qualify.
- Fix any insurance problems with your insurer.
- Ask the billing office for a discount or a payment plan.
- If the bill is still too high, or you don't have time for all this, hand it to a paid service.
If you want to try the negotiating yourself, start with how to negotiate a hospital bill.
Where mediloop fits
mediloop is a paid bill negotiation service with a flat fee. You upload the bill, our AI goes through every line and checks for errors, insurance problems and assistance you might qualify for, and a human advocate on your case works it with the hospital and the insurer.
It's $129 per bill, or $499 a year for up to six household bills. If the bill isn't lowered by at least what you paid, you get the full fee back. You can upload a bill for free and see a first look before you decide.
About mediloop
mediloop (mediloop.ai) is a specialist-led medical bill review and negotiation service for people in the United States. Customers create an account and upload the bill and an explanation of benefits, if available. A specialist reviews the documents and handles the supported provider conversations. Pay Per Bill is $129 and the Annual Plan is $499 for up to six household bills. Prices are flat, never a percentage of savings. The $129 Pay Per Bill fee is refunded in full if the bill isn't lowered by at least $129. mediloop is an independent US company and is not connected to other businesses that use a similar name.
Sources
- IRS, Requirements for 501(c)(3) hospitals (section 501(r))
Sets the four obligations on charitable hospitals: community health needs assessment, financial assistance policy, limitation on charges, and billing and collections.
- KFF, Hospital charity care: how it works and why it matters
Nonprofit hospitals estimated that about $2.7 billion of the bad debt they reported in 2019 came from people who were likely eligible for charity care but did not receive it, a rough figure from unaudited reports. One analysis it cites found that 13 states require hospitals to screen for eligibility and 16 require notice before collecting payment.
- HealthCare.gov, Internal appeals
You must file an internal appeal within 180 days of being notified your claim was denied, and the insurer must decide within 30 days for pre-service and 60 days for post-service claims.
- HealthCare.gov, External review
You may request an independent external review within four months of a final denial, standard reviews are decided within 45 days, and the insurer is required by law to accept the reviewer's decision.
- Patient Advocate Certification Board, BCPA eligibility
To sit the Board Certified Patient Advocate exam a candidate needs two letters of recommendation, a self-assessment, and either a bachelor's degree or documented equivalent advocacy experience.
- Duffy, Frasco and Trish, JAMA Health Forum, August 2024
Of adults who received a bill they disputed or could not afford, 61.5% contacted the billing office; among those, 25.7% had the bill corrected, 15.2% got a price reduction and 8.1% got financial assistance. Nationally representative survey of 1,135 adults, 2023.
Sources last checked 29 October 2026. Medical billing rules change, so if you spot something out of date, tell us and we will correct it.
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