First free care. Then check the bill like an auditor.

The recurring errors

• Duplicate charges. The same lab, imaging study, or medication charged twice — often once from the department and once from the floor. Look for identical codes on the same date.
• Services never rendered. Charges for tests, therapy sessions, or supplies that never happened. Your memory, the discharge summary, and the patient portal notes are the cross-check.
• Wrong-code upcharges ("upcoding"). A more complex — pricier — code than the service documented: a higher-level office or ER code, a complicated procedure code for a simple one.
• ER level inflation. Emergency visits are billed at levels 1–5. Level 4–5 pricing for a visit that was, documented, straightforward is one of the most common inflation points in American billing.
• Unbundling. Supplies and services that belong inside a package rate (surgical trays, routine nursing supplies, IV start kits) charged separately line by line.
• Time and quantity errors. Operating-room and anesthesia minutes rounded beyond the record; medication quantities above what the administration record shows; room days beyond the stay.
• Cancelled-service charges. Tests ordered then cancelled still printing on the bill.

How a dispute runs

1. Request the itemized bill (and, for big bills, your medical record for the stay — you have a federal right to it).
2. Mark each suspect line: date, code, charge, and the reason ("not in record," "duplicate of line 114").
3. Send the dispute to the billing office in writing, line by line, and ask for a corrected bill and an account hold while it's reviewed.
4. Keep the assistance application moving in parallel — errors reduce the bill; assistance can erase what remains.