The short version
If you are uninsured or paying for care yourself, the provider generally has to give you a Good Faith Estimate before scheduled care. If the final bill is $400 or more above that estimate, you can open a federal dispute within 120 days of the first bill. The filing fee is $25, collections pause during the dispute, and if the decision lowers your bill, the fee is credited against what you owe.
Check your estimate against your bill, freeEnter the estimate, the bill, and the first bill date. The checker does the gap math and your deadline.
Who can use this dispute
- You were uninsured, or you chose not to use your insurance for this care (self pay).
- You received a Good Faith Estimate for the service.
- The billed amount is $400 or more above the estimate for that provider.
If you used insurance, this specific dispute is not available. Your route is the bill versus EOB check and, for a denial, an appeal.
The steps
- Put the estimate and the itemized bill side by side, line by line, and find where the extra amount appeared.
- Call the provider first. Billing errors get fixed on the phone more often than any other way, and a corrected bill ends the problem.
- If the gap stands, open the patient provider dispute through CMS within 120 days of the first bill. The No Surprises Help Desk at 1-800-985-3059 will walk you through it.
- Keep the original estimate. The dispute is decided against that document.
Two protections while you decide
- Once the dispute is open, the provider must pause collections on the disputed amount.
- The provider cannot move the bill to collections or threaten to while the dispute runs.