Audit Medical Bills and Recover Insurance or Provider Overpayments
Reconcile bills against explanations of benefits, challenge coding or payment discrepancies, and secure corrected balances or refunds for verified overpayments.
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Who it's for
US patients who suspect they are overpaying for care — those juggling multiple bills, recent hospital stays, or out-of-pocket charges that don't match their insurance statements. Best for people with insurance, or who paid a bill themselves, and who can spare several sittings over a few weeks. Not for uninsured patients seeking charity care, which is a different negotiation.
About this playbook
This guide turns a stack of confusing medical bills into an auditable ledger you can verify line by line against your insurance company's explanations of benefits. You will gather every bill, EOB, and payment record for a review window, then reconcile each charge against what your plan actually allowed and paid. You will learn to spot duplicates, coding mistakes, and arithmetic errors, and to classify each one so you know whether to call the provider's billing office or file a claim appeal with your insurer. The disputes you file use the documents, addresses, and deadlines that get results, and confirmed overpayments are refunded in writing. The guide does not cover charity care or financial-assistance negotiations for uninsured patients, nor lawsuits against providers or insurers.
What you'll do, step by stepFree preview
Only a sample is open: 3 of 18 steps can be read in full. The rest unlock when you buy.
Phase 1: Assemble Your Records
4 stepsPhase 2: Audit Bills Against Explanations of Benefits
5 stepsPhase 3: Dispute Charges and File Appeals
5 stepsPhase 4: Recover Overpayments and Close the Audit
4 steps
Details
What you need first
You have at least one medical bill or explanation of benefits to audit, your insurance card and plan documents (or member portal access), and any payment receipts or statements. You will need a spreadsheet program or paper ledger, plus access to a phone, email, and regular mail. You can start with a single bill and expand the review window later.
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