Audit a large hospital bill against Medicare rates and coding rules
Demand an itemized bill with codes, have AI check for duplicates, unbundled components and wrong setting codes, estimate the Medicare-allowed amount, then make a written lump-sum offer.
Real-world reports
- Business Insider: 'I used Claude to negotiate $163,000 off a hospital bill'
- Tom's Hardware coverage (unverified by publisher)
Self-reported results; not independently verified by us. Your outcome will differ.
Tools
- ChatGPT, Claude, Gemini or Grok (free tiers work; paid ~$20/mo helps with long files)
- Itemized bill with CPT/HCPCS codes
- CMS Physician Fee Schedule lookup
- Hospital price transparency file
Steps
- Request an itemized bill with CPT/HCPCS and revenue codes in writing; you are entitled to it.
- Redact identifiers, paste or upload codes. Ask AI to flag duplicates, NCCI unbundling, mutually exclusive codes and inpatient-vs-outpatient mismatches.
- Cross-check rates in the CMS fee schedule tool; have a second AI review the first's work.
- Ask about the hospital's financial assistance policy (nonprofits must have one).
- Send a written dispute citing each issue and offering a prompt lump sum; ask that the account be held from collections during review.
- Get any settlement in writing showing a zero balance.
Copy-paste prompt
Here are itemized hospital charges with CPT/HCPCS codes [PASTE]. Patient was [ER/inpatient/outpatient]. Flag possible duplicate charges, NCCI unbundling, mutually exclusive pairs, and setting mismatches. For each code estimate the Medicare national allowed amount and cite where I can verify it. Mark anything uncertain.
What to verify
AI can misread codes and invent rates. Verify each rate in CMS tools; consider a patient advocate for very large bills.
Legal & ethical notes
Not legal advice. Be factual in letters; don't threaten anything you won't do.
Go deeper on money workflows with AI Money Playbooks: verify-first AI prompts for budgeting, bookkeeping, bills and taxes.
Official sources
- CMS Physician Fee Schedule search
- CMS hospital price transparency
- IRS 501(r) financial assistance rules
Educational only; not legal, tax, medical or financial advice. Laws and prices change; check official sources.
Related recipes
Apply for hospital charity care you may qualify for
Find the hospital's FAP, have AI check your eligibility against it and assemble the application, even for past bills.
Savings: Illustrative: nonprofit hospitals often discount or forgive bills for households under set income levels (commonly up to 200-400% of the pov…
Fight an out-of-network surprise bill with the No Surprises Act
AI checks whether your bill is protected and drafts the dispute; uninsured patients can use the Good Faith Estimate dispute if billed $400+ over estimate.
Savings: Illustrative: emergency and certain in-network-facility surprise bills can be cut to your in-network cost share, often hundreds to thousands…
Catch errors on routine medical bills and EOBs
Compare the provider bill with your insurer's EOB; AI spots mismatches and writes the billing-office call script.
Savings: Illustrative: billing errors like duplicate charges or claims not sent to insurance often mean $50-$1,000 per bill.
One tested AI recipe every week
Free weekly email: one use case, the exact steps, what it costs, and what to double-check. No hype.
Newsletter launches soon.