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Understanding Your Medical Bills: What’s Normal, What’s Not, and When to Fight Back

July 4, 2025
Advocacy, Insurance & Billing
  • Introduction

You shouldn’t need a law degree to read a medical bill — but for many people, that’s exactly how it feels. Between confusing codes, duplicate charges, and surprise out-of-network fees, understanding what you actually owe (and why) can be overwhelming.

The truth is, billing mistakes are common. In fact, studies show that up to 80% of medical bills contain errors. That’s why knowing what to look for — and when to challenge a charge — can save you real money and stress.

As a Personal Healthcare Advocate, I help clients decode their bills, resolve disputes, and regain peace of mind. Here’s what you need to know.

1. Know the Difference: EOB vs. Medical Bill

First, understand what you’re looking at:

  • EOB (Explanation of Benefits): Sent by your insurance company. It’s not a bill — it just shows what was billed, what was covered, and what you might owe.
  • Medical Bill: Sent by your provider. This is what they believe you owe after insurance.

Always compare the two before paying anything.

2. Common Billing Errors to Watch For

Some mistakes are simple — others are expensive. Look out for:

  • Duplicate charges for the same service or procedure
  • Charges for services you didn’t receive
  • Incorrect billing codes (e.g., a specialist visit coded as emergency)
  • Out-of-network charges when the provider was actually in-network
  • Unbundled charges (billing separately for items that should be grouped)

3. What’s “Normal” — Even If It Feels Confusing

Not all scary-looking charges are wrong. Examples of what might be correct:

  • Facility fees for using a hospital or clinic space
  • Lab fees billed separately from your provider
  • Deductibles or coinsurance amounts if you haven’t met your yearly out-of-pocket max

Still, it’s worth confirming. If something looks off — ask.

4. When (and How) to Fight Back

You have the right to dispute a bill, and in many cases, you should. You can:

  • Call the provider’s billing office and ask for an itemized bill
  • Compare with your EOB to find discrepancies
  • Request a review or rebill if a code is incorrect
  • File an appeal with your insurance for denied or underpaid claims
  • Get help — from a billing advocate or a healthcare advocate like me

Persistence matters. Mistakes are often reversed once they’re identified and challenged.

5. Keep Records, Stay Organized

Keep copies of:

  • Bills
  • EOBs
  • Letters from your provider or insurance company
  • Notes from phone calls (including date, time, and who you spoke with)

This documentation can make or break your ability to dispute successfully.

Need Help with a Medical Bill?

You don’t have to face it alone. Whether you’re overwhelmed by paperwork, dealing with a denied claim, or simply don’t understand why you owe so much — I can help.

As a personal healthcare advocate, I work one-on-one with clients to:

  • Review and explain bills and insurance lettersIdentify and dispute billing errorsCoordinate communication between provider and insurerReduce out-of-pocket costs when possible

📞 Schedule a free consultation to get expert support and take control of your healthcare expenses.