How medical bill help services charge.

The four models

Ranges reflect publicly-reported industry norms. Each provider sets its own rates — verify before deciding.

DIY — $0 and several hours

Every hospital in the U.S. is required by federal regulation (45 CFR §180.50) to publish a machine-readable file of every charge. Medicare’s Physician Fee Schedule and the NADAC drug-pricing database are also public. The DIY path is to pull your bill’s CPT, HCPCS, and DRG codes, look each one up in those files, and flag anything that’s billed above the published rate.

Best for: patients with technical comfort, time, and a bill that’s straightforward.

Trade-off: the public files are large, the file formats vary by hospital, and the bundling rules (NCCI edits) take real time to learn. Most people abandon this path after the first hospital’s CSV.

Flat-fee audit — $20-50 and a minute

A flat-fee audit is software that does the DIY work for you. You upload a bill, the system checks every line against six federal data sources (CMS Physician Fee Schedule, NADAC, Hospital Price Transparency, NCCI bundling edits, Hospital Compare quality data, IRS Pub 78 charity-care registry), and you get back a report listing any line items billed above the federal benchmark or where bundling rules suggest the code shouldn’t have been billed separately.

Best for: bills of any size where you want a fast, comprehensive check and don’t mind taking the dispute back to the hospital yourself.

Trade-off: the audit identifies what to dispute; you still call billing, send the letter, and follow up. The software is the assistant, not the negotiator.

MediBill Saver is a flat-fee audit. $19.97 for a single bill, with a 30-day money-back guarantee.

Contingency negotiation — 25-35% of savings

Contingency services charge nothing upfront, then take a percentage of whatever they save you. You hand them the bill, sign an authorization, and they negotiate with the hospital on your behalf. Their incentive is aligned with finding savings — they only get paid if you save money.

Best for: people who want a hands-off experience and would rather hand the bill to someone else than read a report.

Trade-off: the math on a large bill. A 30% cut of $1,500 in savings is $450. A 30% cut of $4,000 in savings is $1,200. The percentage fee scales with how much they save — which means the more disputable charges on your bill, the more you pay for the same software-detectable findings.

Hourly billing advocate — $50-200/hr

Professional billing advocates (often credentialed coders or RNs) work case-by-case on hourly retainer. They handle the audit, the negotiation, the appeals, and the paperwork. Some specialize in insurance disputes; others focus on hospital billing departments.

Best for: complex cases — contested coverage decisions, hospitals refusing to itemize, multi-payer coordination, or appeals against denied claims.

Trade-off: cost scales unpredictably with case complexity. A straightforward audit doesn’t need an hourly professional; an active legal dispute might.

Which model fits

• Bill under $500: DIY or a flat-fee audit. Contingency math rarely justifies the friction at this size.
• Bill $500-$10,000: flat-fee audit is the sweet spot — fast, comprehensive, you keep 100% of savings.
• Bill over $10,000 with simple line-item errors: still a flat-fee audit. The errors are the same regardless of bill size; the percentage fee on a $50,000 bill can easily exceed $1,000.
• Active coverage dispute or denied claim: hourly advocate or attorney. Software can’t appeal a denial; people can.
• You want zero involvement: contingency negotiation. You’ll pay more, but you don’t read a report or make a call.

Frequently asked