Sample Protest Letters to Medical Providers
Note: get the name, if you can, of a person in charge of the hospital’s or other provider’s billing and direct the letter to him or her.
A Sample Letter Requesting Medical Records or Itemized Bills When a Provider Fails to Provide Them
Dear :
I have still not received from you the material I requested. This is my (second, third, fourth, etc.) request for (my medical records/a bill itemizing charges for X procedure performed at your facility or hospital admission to your facility on X dates).
According to the Health Insurance Portability and Accountability Act (HIPAA), I have a right to receive these records within 30 days and to pay no more than a reasonable handling or processing fee for them.
If I do not receive the requested material soon (or by X date), I will file a complaint with the federal Health and Human Services Office for Civil Rights, which prosecutes HIPAA violations.
Sincerely yours,
A Sample Letter Challenging Billing Errors or Outrageous Charges (pick the sections that apply)
Dear:
I write to protest excessive charges (and/or errors) reflected on the bill I received for my (X procedure or hospital stay) at your facility on (X dates).
I was billed a total of $_____ for this procedure. The total includes charges that far exceed the norms for our region. These excessive charges are
$____ for (name procedure)
$____ for (name procedure)
Etc.
I have consulted the Healthcare Bluebook, which lists fair prices for these procedures. They are
$____ for (name procedure)
$____ for (name procedure)
Etc.
My bill lists charges for treatments I never received. These charges and treatments include
$____ for (name procedure)
$____ for (name procedure)
Etc.
Before I send payment, I ask your billing department to review my chart and my bill and to revise the charges to reflect a fair price for our region or explain to me in writing the reasons for the high charges on my current bill.
Before I send payment, I ask your billing department to review my chart and my bill and to correct the errors I have noted or explain to me in writing why they are not errors.
(If true, add one or more of the following.) I have been served by your hospital (other provider) for a long time. I appreciate the quality of treatment you provide. I have always paid what I owe you on time. But if you do not resolve these billing issues, I will report them to the state attorney general with a request to investigate abusive billing practices.
Sincerely yours,
Letter Responding to A Surprise Out-of- Network Bill
Dear:
On (X date), I was admitted to (had X procedure performed at) (name of hospital, medical center, clinic, etc.) I chose (name of hospital, medical center, clinic, etc.) because it is in my insurance network. Yet I have received a bill for out-of- network services performed at your facility. A copy of this bill is enclosed.
I was never informed of the out-of- network status of the providers and procedures listed on the bill. I therefore did not give informed consent for treatment beyond the terms and network of my health insurance coverage, and I therefore will not pay out-of- network prices for the services I received.
I suggest you contact my insurer to work out payment.
Please stop immediately your effort to collect a bill I do not owe for services that I was never informed would be charged at out-of- network rates. If I get another collection notice or bill for out-of- network services, I will report your collection efforts to the Wisconsin State Commissioner of Insurance and to the Wisconsin State Department of Consumer Affairs.
Sincerely yours,
These samples are based on templates suggested by Elizabeth Rosenthal in An American Sickness: How Healthcare Became Big Business and How You Can Take It Back. New York: Penguin, 2017, 346-48.