The Process

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MDS’s system of fighting unfair billing is centered on “Denial of Payment”. The core of this process is simply to demand information we believe every patient is entitled to, but that hospitals refuse to provide. This information includes price lists, explanations of how prices are derived, bills that detail the services provided, details of the negotiations with insurance companies, uninsured discount policies and evidence that the hospitals are complying with price laws. Our website is here to provide patients with the information they need to properly and effectively fight these unfair bills and to ultimately change the system. We will also offer advice, help draft letters, communicate with hospitals and collection agencies and, when necessary, provide pro-bono legal representation to patients.

 

The First Step

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The first step in our process is to contact the hospital and request the following information

  1. A detailed copy of the bill
  2. A copy of the hospital’s price list for all related services (see example letters)
  3. An explanation of how the prices are derived
  4. An explanation of how any discounts were derived

INSERT IMAGE AND LINK TO EXAMPLE LETTERS

What To Do When The Hospital Responds

In our experience, you will likely receive a response with reasons why they cannot provide all of this information. This is absurd. This is all information every patient should have the right to know. After all, you should know what you are paying for. Upon receiving a response, the next step is to follow these guidelines:

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  • If there is not enough detail so that you fully understand the bill, ask for more detail.
  • If they don’t include the price list, explain that you simply don’t have the confidence that you are being billed for the right services because you don’t know what other similar services they might have confused yours with.
  • If they have not explained the system by which prices are derived so that you understand it, request that they try again. Do not accept that it is too complicated. They have an obligation to explain their prices in a manner that you can understand.
  • If they do not explain their discounts or say that you should check with your insurance company, remind them that it is them (the hospital) and not your insurance that is asking you for money. If your bill was reduced because your insurance company paid part of it, demand a copy of the agreement between them and your insurance company. It is not your problem that they say it is “confidential”.
  • On your second letter, be sure to end with: “Because i still do not have adequate explanation of my bill, I am formally disputing this bill. Should you decide to send my bill to a collection agency, be sure to mark the file, “DISPUTED”.
  • Feel free to contact us for any help you may need drafting these letters.

 

Third and Fourth Letters

Be clear with the hospital that you are disputing your bill and will not pay it until you receive all of the information you have requested. They will send you all kinds of explanations for why they can’t answer your questions. They’ll tell you things are private ore confidential, they will tell you that there are just too many things that can happen in a hospital or hospital ER to list them all, they’ll tell you that things are complicated, or are based on a system, or that they adhere to “benchmarks” and “standards”. It’s all nonsense until they actually prove it to you and you are entitled to this information. They will also argue that they can’t possible provide so all this information to every patient. That is also nonsense. They could simply put all of the information on their website once.

The Bottom Line

You cannot be asked to pay more than you were originally billed. So what do you have to lose? While we cannot guarantee that you will never have to pay your bill or the ultimate outcome in your individual case, based on our experience, you shouldn’t just accept that you have received the correct bill. We can’t anticipate how hospitals will respond to this problem when enough of us make it a big problem. By challenging your bills and refusing to pay, you are not just saving yourself money. You are becoming part of a cause. You are helping others by being a part of an ever-growing group of people that are fed up. Only when enough of us deny payment to hospitals will they change their ways. We are trying to bring the system to its knees.

To do it yourself, download our Packet

 

Need Extra Help? Let Us Help You!

We offer advice, provides templates and a process anyone can follow, draft letters, contact hospitals and collections agencies, and even provide pro-bono legal representation. Feel free to Contact us and we will help you challenge hospital bills!