Jordan Lee
12 Elm St, Dayton, OH 45402
Re: Request for an itemized bill. Account 448120.
To the billing office:
I received a bill for $4,210 for care on June 3, 2026. Please send me a complete itemized bill that shows, for each charge, the date, the billing code, the quantity and the amount, and every payment and adjustment applied.
While I review it, please do not send this account to a collection agency.
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Medical bill look wrong? Ask for the itemized bill.
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Also: a letter asking a collector to prove the debt and a charge dispute letter.
For the phone calls
The Medical Bill Fight Kit
A 9-page PDF you print: the order of steps, word-for-word call scripts for the billing office, your insurer, financial assistance and a collection agency, five letters with blanks (the three free ones here, plus a financial assistance request and a payment agreement confirmation) and a call and mail log.
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Read the guide for your bill
Getting an itemized bill
What to ask for, what to check on it, and a letter to send.
A medical bill in collections
Ask the collector to prove the debt before you pay or agree to anything.
Charges that look wrong
Duplicates, services you didn't get, wrong codes: dispute them in writing.
A surprise out-of-network bill
Emergency care or an out-of-network doctor at an in-network hospital.
A self-pay bill over the estimate
Uninsured or paying yourself, and the bill came in far higher than quoted.
More letters and checklists
How to dispute a medical bill
The steps in order, with a checklist.
Check a bill for errors
A line-by-line checklist for the itemized bill.
EOB and bill don't match
A letter asking the billing office to correct it.
Surprise bill letter
Ask the provider for a No Surprises Act review.
Negotiate a hospital bill
A written offer to settle for less.
Ask for a payment plan
A letter with the monthly amount you choose.
Hardship letter
Ask to reduce or forgive a bill you can't pay.
Financial assistance
Ask a hospital for its charity care policy.
Medical bill on your credit report
Dispute a wrong entry with the credit bureau.
Medical bill call log
A printable log of every call.
General information, not legal, medical or financial advice. Ask a lawyer before acting on it.