Build your case
Get your medical records and itemized bill
Request the records that prove the need, and the itemized bill that shows what was actually charged.
Do this today
- Use the tool: Records and bill request builder Build requests for your medical records and an itemized bill.
- Read: How to ask for an itemized bill and check it 5 minute read. Ask the provider for every charge on your account, then compare it with your Explanation of Benefits to find errors. Covers the billing-records right you do have and the itemized-bill right the federal rules do not give.
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Put this step on My Plan
So you can come back to it, and keep your dates and calls in one place.
In brief
- This site found no general federal law that requires an itemized bill for insured patients. Many states have their own rules.
- The federal health privacy rule gives you a right to a provider's billing records, which a provider must act on within 30 days, with one extension of up to 30 more days.
- After a denial, a plan that is not grandfathered must give you the diagnosis and treatment codes and their meanings on request.
- Compare the itemized bill with your Explanation of Benefits before you pay, and ask the provider to correct errors and resend the claim.
Read the full guide: How to ask for an itemized bill and check it
More guides, tools and letters
More guides, tools, letters 6
Guides
- How to ask for an itemized bill and check it
Ask the provider for every charge on your account, then compare it with your Explanation of Benefits to find errors. Covers the billing-records right you do have and the itemized-bill right the federal rules do not give.
- How to get your medical records
Ask your doctor, hospital or clinic in writing for a copy of your own records for your appeal. Covers what the federal health privacy rule says about timing and fees, and which records an appeal needs.
Tools
- Tool
Records and bill request builder
Build requests for your medical records and an itemized bill.
Letters and scripts
- Letter or script
Ask for an itemized bill
A written request to a provider for an itemized statement of every charge, code, payment and adjustment on your account, so you can compare it with your plan's Explanation of Benefits before paying.
- Letter or script
Ask for your medical records
A written request to your doctor, hospital or clinic for a copy of your own medical record under the federal health privacy rule, for use in your appeal.
Programs and services
- Program or service
Health Insurance Portability and Accountability Act right of access to your health information
The federal guidance on your right to see and get copies of your records held by your health plan and most providers, and to have them sent to someone you name.
From U.S. Department of Health and Human Services
Questions to keep handy
- What exactly was denied, and under which part of the plan?
- What is my deadline, and what is it counted from?
- Where and how do I send my request, and how will I prove it arrived?
- Who decides, and can I ask for a faster decision?
Not what you need? Find a person who can help, or search the whole site.