I have a medical bill
Do I need a medical billing advocate?
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Often, no. Many bills can be sorted out on your own: get the itemized bill, compare it with your Explanation of Benefits, and ask about financial assistance. Paying an advocate makes sense when the bill is large, several providers or insurers are involved, the same error keeps coming back, or you simply don't have the time or energy right now.
What to do
- Try the free steps first: ask for the itemized bill, compare it with your Explanation of Benefits (EOB), and ask the hospital for its Financial Assistance Policy.
- Ask the hospital if it has a patient advocate or financial counselor on staff. That help costs you nothing.
- If you hire an advocate, get the price, what is included and how they are paid in writing before any work starts.
What to say
How do you charge: by the hour, a flat fee, or a share of what you save me? If it's a share, how do you work out the savings?
Ask it before you sign anything. A clear answer, in writing, is a good sign.
What to watch out for
This is a sensitive stepSmall details here can change the outcome, and some mistakes are hard to undo. We highly recommend a free 15-minute call with us before you decide.
Paying up front for a promise. CMS warns against paying anyone who asks for an upfront fee to resolve your debt, or who promises to keep medical bills off your credit report. No honest advocate can guarantee a result.
Also: a share of "savings" counted from the full list price. Ask how savings are measured before you agree to a percentage.
Better done together
We’re here to help
Plenty of bills can be sorted out with our free answers and the Bill Appeal Kit. When a bill is large, involves several providers, or keeps coming back wrong, it helps to have someone who knows where to look and what to ask.
Start with a free 15-minute call. We'll tell you honestly whether you need us or can handle it yourself. If we're a fit, you get a written not-to-exceed estimate first, then $150 an hour, billed to the minute. We never take commissions from insurance companies, and we don't take a cut of what you save.
Every situation is different, and these are sensitive moments, so we look at yours with care. We often see what others miss, and we never take commissions from insurance companies: the only thing we are working for is what is right for you.
Free · 15 minutes · No pressure
The rule behind it
No law says you need an advocate. You can ask for an itemized bill, question a charge and apply for financial assistance yourself. Nonprofit hospitals must have a written Financial Assistance Policy under IRS rule 501(r). CMS notes that many hospitals have patient advocates on staff who can help you understand a bill, apply for financial assistance and get your medical records. CMS also warns against paying anyone who charges an upfront fee to resolve debt or promises to keep bills off your credit report. For an advocate to receive your health information from a hospital or insurer, you will usually sign a written permission (a HIPAA authorization, 45 CFR 164.508).
Sources
- CMS — Find a patient advocate to help you navigate the healthcare system
- IRS.gov — Financial Assistance Policies (Section 501(r)(4))
- CFPB — Consumer advisory: your rights with medical debt collectors (October 2024, archived)
- 45 CFR 164.508 — HIPAA authorizations
Amanda Alcodia
Last reviewed: October 2026
Education, not medical, legal or insurance advice.
Useful next steps
Start with the free Kit. If your situation needs a person, the intro call is free too.