Build your dispute kit

Fill in your bill once. All four documents are written around your hospital, your procedure code, and that hospital's own published price — before you pay anything.

1 · Your bill

2 · Preview your documents

3 · Unlock & download

Your name

Account / bill number

Hospital / billing entity

Date of service

State

CPT / HCPCS code

Amount billed for that line ($)

Total bill ($, optional)

1 · Itemised bill request

2 · Escalation letter

3 · Agency complaint

4 · Price exhibit

Unlock the full kit — $14.99

4 documentsbuilt from your bill editable .txtre-downloadable

Everything above is yours in full — complete letters, the agency routing, and the price exhibit — ready to copy, edit and send.

One-time. Not a subscription — nothing auto-renews. Digital product delivered immediately, so all fees are non-refundable. See Terms. Already bought it? Recover your kit.

How to use these

Stage 1 — Billing office, in writing. Send the itemised request first and wait for the coded bill. Do not argue price before you have line items; you cannot dispute what you cannot see. Ask them to pause collection while the request is open.

Stage 2 — Patient advocate or financial counsellor. Most hospitals have one, and they hold discretion the billing office does not. This is where the price exhibit does its work: you are showing the hospital its own number.

Stage 3 — Compliance officer, then the agency. Non-profit hospitals have obligations a compliance officer is paid to care about. Send the agency complaint only after Stages 1 and 2 have had a real chance, and say in the letter that you did.

Not legal advice. These are document templates and a price lookup. They do not create an attorney-client relationship and are not a substitute for advice about your situation. Confirm current prices with the facility.