How do I dispute an emergency room bill?

Start by requesting an itemized bill and your UB-04 form from the hospital. Compare the CPT billing codes to your medical records, and look for upcoding, duplicate charges, or services you did not receive. MedicalBillReview.net can review your bill for free and identify errors you can formally dispute.

Is the ER bill review completely free?

Yes. MedicalBillReview.net provides a completely free, independent review of your emergency room bill. There is no cost to you at any point.

What is upcoding on a medical bill?

Upcoding is when a hospital bills for a higher level of care than was actually provided. For example, billing CPT code 99285 (the highest complexity ER visit) when the actual visit was a routine 99282. This is one of the most common and costly billing errors on ER bills, and it is something we specifically check for in every review.

What does the No Surprises Act cover for ER bills?

The No Surprises Act protects patients from unexpected out-of-network charges at in-network facilities, including emergency rooms. In most cases, you cannot be billed more than your in-network cost-sharing amount for emergency care, regardless of which doctor treated you.

What billing errors are most common on ER bills?

The most common ER billing errors include: upcoding (billing a higher level of care than provided), unbundling (charging separately for services included in a flat rate), duplicate billing (charging twice for the same service), and errors in medication quantities or supply units.

How do I get an itemized bill from a hospital?

You have a legal right to an itemized medical bill. Contact the hospital billing department and specifically request an itemized statement and the UB-04 claim form. Under federal law, hospitals must provide your medical records within 30 days of a written request.

How to Request an Itemized Medical Bill (And ER Medical Records)

Getting your medical records is the first step in auditing a confusing ER bill. Under HIPAA, you have a legal right to access your health information. Here is exactly how to do it.

How Do I Get My ER Records?

Contact the hospital's Medical Records or Health Information Management (HIM) department and submit a formal written request. You are entitled to both your clinical records (physician notes, nursing notes) and your billing records (itemized statement, UB-04 form).

What Records to Request

Medical Records (from the Medical Records / HIM Department)

ED Provider Note — physician's clinical assessment
Triage Note — ESI level and initial vitals
Nursing Notes — all entries during your visit
Orders — labs, imaging, medications, IV fluids ordered
MAR — Medication Administration Record
Lab Results & Radiology Reports
Encounter time stamps (arrival, triage, provider contact, discharge)

Billing Records (from the Billing / Patient Financial Services Department)

Itemized Bill — line-item detail, not just a summary statement
UB-04 / CMS-1450 — the official facility claim form
CPT/HCPCS Codes and Revenue Codes billed
ICD-10 Diagnosis Codes

Your HIPAA Rights

Under federal law, you have the right to access your medical records. Hospitals must provide them within 30 days of a written request. Digital copies (PDF via patient portal) are often free or low-cost. Colorado has additional state rules limiting copy fees.

Common Issues When Requesting Records

Hospitals sending a "Summary" instead of an "Itemized Bill" — insist on the itemized version
Charging excessive fees for digital records — PDFs should be low or no cost
Claiming records are "lost" or "unavailable" — this is rarely true
Requiring in-person pickup when mail or electronic delivery was requested

Script: What to Say When You Call the Billing Office

"Hi, I'm calling about my visit on [Date]. I need a fully itemized bill and the UB-04 (or CMS-1450) claim form. Can you send these to me electronically via the portal or secure email?"

If they say "we don't give UB-04": "This is a standard claim document used for billing. Please note my request and escalate to a supervisor if needed — I'm requesting it for review."

When to Question the Bill

You have the right to an Itemized Bill showing every single charge
You have the right to the Physician Notes explaining the level of care
Hospitals must provide records within 30 days of your written request
Digital copies are often provided through a patient portal for free

Submit your records to us for a free ER bill review →