Medical billing
Medical bill — request for an itemised statement
Always the first step. A summary bill cannot be checked; an itemised one frequently reveals duplicate lines, unbundled charges and services never received.
medical.itemised-bill-request8 languages14-day reply window
What it actually says.
Rendered live from invented facts: An emergency admission at an in-network hospital, billed by an out-of-network physician. The claimant is fictional and the figures are illustrative — your own claim produces its own numbers and its own citations.
The authority in the preview
It cites the article, not the act.
A document has to name the provision it relies on or it gets filed. These are the citations the sample evaluation put into the letter above; a real claim substitutes the ones its own regimes produced.
- 42 U.S.C. § 300gg-131No Surprises Act§ 300gg-131(a)
Where it comes from
The laws that can produce this document.
A rule module declares the documents its evaluation can render into. These are the regimes in the current catalogue that offer this one — each with its own citations, deadlines and escalation ladder.
EU cross-border healthcare — Directive 2011/24/EU reimbursement, the EHIC and the S2EUSupranational — 27 countriesDirective 2011/24/EU, Arts. 6, 7 and 8Confidence: highFrance — dépassements d'honoraires, secteur 1 and 2, and the OPTAMFRNational — FranceCode de la santé publique, art. R. 4127-53Confidence: mediumGermany — the GOÄ and GOZ private billing schedules and their multiplier limitsDENational — GermanyGebührenordnung für Ärzte (GOÄ), §§ 2, 5 and 12Confidence: mediumIreland — public hospital charges, medical cards and the HSE complaints routeIENational — IrelandHealth Act 1970 (as amended)Confidence: lowItaly — Servizio Sanitario Nazionale, the ticket and the URP routeITNational — ItalyLegge 23 dicembre 1978, n. 833Confidence: lowNetherlands — NZa tariffs, the eigen risico and the SKGZ dispute routeNLNational — NetherlandsWet marktordening gezondheidszorg (Wmg), art. 35Confidence: mediumSpain — Sistema Nacional de Salud coverage and the right to economic informationESNational — SpainLey 41/2002, de autonomía del pacienteConfidence: lowUnited Kingdom — NHS charging, overseas visitor invoices and private healthcareGBNational — United KingdomNational Health Service Act 2006, s. 1(4)Confidence: mediumArizona surprise out-of-network bill dispute resolution (A.R.S. § 20-3111 et seq.)US-AZSub-national — United StatesA.R.S. § 20-3111 et seq.Confidence: mediumCalifornia surprise-billing protections (AB 72; Health & Safety Code § 1371.9)US-CASub-national — United StatesCal. Health & Safety Code § 1371.9Confidence: mediumCanada — the Canada Health Act prohibition on extra-billing and user chargesCANational — CanadaCanada Health Act, R.S.C. 1985, c. C-6, ss. 18-19Confidence: mediumColorado out-of-network payment and hold-harmless (C.R.S. § 10-16-704)US-COSub-national — United StatesC.R.S. § 10-16-704Confidence: mediumConnecticut surprise-bill protections (Conn. Gen. Stat. § 38a-477aa)US-CTSub-national — United StatesConn. Gen. Stat. § 38a-477aaConfidence: mediumFlorida balance-billing protections (Fla. Stat. §§ 627.64194 and 641.3154)US-FLSub-national — United StatesFla. Stat. § 627.64194Confidence: mediumGeorgia Surprise Billing Consumer Protection Act (O.C.G.A. § 33-20E-1 et seq.)US-GASub-national — United StatesO.C.G.A. § 33-20E-1 et seq.Confidence: mediumIllinois Network Adequacy and Transparency Act (215 ILCS 124)US-ILSub-national — United States215 ILCS 124/25Confidence: mediumMaine surprise-bill protections (24-A M.R.S. § 4303-E)US-MESub-national — United States24-A M.R.S. § 4303-EConfidence: mediumMaryland non-participating provider reimbursement (Md. Code, Insurance § 14-205.2)US-MDSub-national — United StatesMd. Code, Insurance § 14-205.2Confidence: lowMichigan out-of-network care provisions (Public Acts 234 and 235 of 2020)US-MISub-national — United StatesMichigan Public Acts 234 and 235 of 2020, amending the Public Health Code and the Insurance CodeConfidence: lowNew Hampshire balance-billing protectionsUS-NHSub-national — United StatesNew Hampshire insurance statutes on out-of-network and emergency care billingConfidence: lowNew Jersey Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability ActUS-NJSub-national — United StatesN.J.S.A. 26:2SS-1 et seq.Confidence: mediumNew Mexico Surprise Billing Protection Act (NMSA 1978, §§ 59A-57-1 to -11)US-NMSub-national — United StatesNMSA 1978, §§ 59A-57-1 to -11Confidence: mediumNew York surprise bill protections (Financial Services Law art. 6)US-NYSub-national — United StatesN.Y. Financial Services Law art. 6, §§ 601-607Confidence: mediumOregon out-of-network provider reimbursement (ORS 743B.287)US-ORSub-national — United StatesORS 743B.287Confidence: mediumPennsylvania — federal protections and the Insurance Department routeUS-PASub-national — United StatesPennsylvania Insurance Department consumer servicesConfidence: lowTexas balance-billing prohibition (SB 1264; Insurance Code ch. 1467)US-TXSub-national — United StatesTex. Ins. Code ch. 1467Confidence: mediumGood Faith Estimate and patient-provider dispute resolution (uninsured and self-pay)USNational — United StatesPHS Act § 2799B-6, 42 U.S.C. § 300gg-136Confidence: highMedicare and Medicaid billing limits, the QMB prohibition and the appeals ladderUSNational — United States42 U.S.C. § 1395u(b)(3)(B)(ii)Confidence: highNo Surprises Act (federal balance-billing protections)USNational — United StatesPHS Act § 2799A-1(a), 42 U.S.C. § 300gg-111(a)Confidence: highUS medical billing errors, plan appeals, non-profit hospital obligations and medical debt collectionUSNational — United States45 CFR § 164.524Confidence: highVirginia balance-billing protections (Va. Code § 38.2-3445.01 et seq.)US-VASub-national — United StatesVa. Code § 38.2-3445.01 et seq.Confidence: mediumWashington Balance Billing Protection Act (ch. 48.49 RCW)US-WASub-national — United StatesRCW ch. 48.49Confidence: mediumBrazil — planos de saúde, the ANS rol de procedimentos and the consumer routeBRNational — BrazilLei nº 9.656, de 3 de junho de 1998Confidence: mediumSouth Africa — prescribed minimum benefits and the Council for Medical SchemesZANational — South AfricaMedical Schemes Act 131 of 1998 and the Regulations made under itConfidence: lowUnited Arab Emirates — mandatory health insurance and the emirate health authoritiesAENational — United Arab EmiratesDubai Law No. 11 of 2013 concerning Health Insurance in the Emirate of Dubai, and the Abu Dhabi health insurance schemeConfidence: lowIndia — the Clinical Establishments Act rate-display duty and the consumer forum routeINNational — IndiaClinical Establishments (Registration and Regulation) Act, 2010Confidence: lowJapan — the national fee schedule and the high-cost medical expense benefitJPNational — JapanHealth Insurance Act (健康保険法) and the National Health Insurance Act (国民健康保険法)Confidence: lowSingapore — MOH fee benchmarks, MediShield Life and the licensing routeSGNational — SingaporeHealthcare Services Act 2020Confidence: lowAustralia — Medicare, bulk billing, the MBS and informed financial consentAUNational — AustraliaHealth Insurance Act 1973 (Cth), s. 20AConfidence: medium
The rest of the sequence
Documents are written to be worked through in order: the opening demand, then the answer to whatever they refuse with, then the escalation. Sending the last one first usually costs you the first two.
Medical bill — surprise billing disputeDispute a bill from an out-of-network provider where the protections against balance billing apply.medical.nsa-dispute8 languages30-day reply windowMedical bill — bill exceeds the good faith estimateDispute a bill that came in materially above the written estimate given beforehand.medical.gfe-dispute8 languages30-day reply windowMedical bill — financial assistance applicationApply for charity care. Non-profit hospitals are obliged to have a financial assistance policy and to limit what they charge eligible patients — an obligation that is very widely under-used.medical.charity-care-request8 languages30-day reply window
You send it
Fill in your own facts and this letter writes itself.
The claim wizard produces this document with your figures, your citations and your deadline already in it. You still print it, sign it and post it yourself — that part is not delegable and we would not take it if it were.
Duesday is not a law firm and does not provide legal advice. This document is an editable template assembled from publicly available law. You are responsible for checking that the facts and the law stated are correct for your situation, and you send it yourself in your own name. Nothing here creates a solicitor–client or attorney–client relationship, and no outcome is promised.