FAQS

The first step is to complete the Problem Medical Bill Assessment, with no commitment to pay Patient Fairness.  From the Assessment, Patient Fairness will identify any questions or concerns to raise to the billing provider that may be cause to reduce or eliminate what you owe.  We will also inform you if the medical bill may be subject to the No Surprises Act, should you wish to file a complaint under the No Surprises Act. Then you can decide if you want to become a Patient Fairness customer by using our tools, template correspondence and insights to engage with the billing provider to lower or eliminate the medical bill.

Patient Fairness helps with bills from hospitals, physicians and other medical providers that include charges or other features not fair and reasonable to the patient.  Here are some common examples.

• The patient did not agree to receive the services billed.  
• The patient did not know the services would be charged separately from another provider’s services.  
• The patient did not know in advance of the services and prices that were to be charged, or the provider may have charged more than it said it would.  
• The medical bill’s prices are excessive.  
• The patient did not know the billing provider was not participating in his or her health plan network.  
• The patient’s circumstances did not reasonably allow him or her to assent to pay the charges as billed.

Patient Fairness customers represent themselves and deal directly with providers in disputing and trying to settle problem medical bills.  Patient Fairness uses a structured process to help its customers with guidance and tools to challenge their medical bills. For example, we create a customized Letter of Dispute based on the patient’s concerns, questions, and approval, which Patient Fairness then mails to the medical provider under the customer’s name.

Why do Patient Fairness customers represent themselves?

• They stay in control of decisions on the bill dispute, and decide how and when to settle it;
• They can be their own best advocates to get fair treatment on their medical bills because they know the circumstances and are invested in the outcome of the dispute; 
• They can save significant money using Patient Fairness versus more costly services that charge a percentage of savings off the bill or an hourly fee.

Patient Fairness helps with bills issued for medical services rendered to persons with private, employer and individual health benefits or insurance, or persons who are uninsured or self-pay (not accessing health benefits or insurance for the billed services).  Two primary examples of bills for which Patient Fairness does not offer its services relate to:

1. Patients covered by the government insurance programs of Medicare, Medicaid, TRICARE, Indian Health Services, Veterans Health Administration, and Children’s Hospital Insurance Program (CHIP).
2. Bills for prescription drugs (pharmacy), dental care, and other non-medical services and supplies.

No.  Patient Fairness offers services, tools and information to dispute a problem medical bill, but there is no guarantee that a billing provider will reduce or eliminate the medical bill.  However, even if the billing provider does not reduce or eliminate the medical bill, using Patient Fairness documents your concerns about the bill, and disputes that you owe the bill pending resolution of those concerns. These documented concerns and dispute may serve as a record that may be used if the billing provider pursues collection even after you dispute the bill.

Patient Fairness considers a variety of reasons and circumstances as grounds to dispute a medical bill.  Some of those reasons and circumstances are addressed by the No Surprises Act, while others are not.  The No Surprises Act addresses surprise medical bills for most emergency services, non-emergency services from out-of-network providers at in-network facilities, and services from out-of-network air ambulance service providers.  Patient Fairness’s services may cite the consumer protections of No Surprises Act when they are applicable, but may also employ such considerations as the reasonableness of prices charged, and situations beyond those addressed by the No Surprises Act.

Patient Fairness will inform a customer if a medical bill may be subject to the No Surprises Act, and the customer has the option of filing a complaint under the No Surprises Act in lieu of, or in addition to, using Patient Fairness’s services.  

Persons can complete a Problem Medical Bill Assessment at no charge to find out if Patient Fairness identifies questions or concerns to raise to the Billing Provider that may be cause to reduce or eliminate what you owe.  If a person decides to use Patient Fairness to address the medical bill, Patient Fairness charges a flat $40 fee for access to all of its tools and services related to that medical bill case.

As soon as the Problem Medical Bill Assessment is completed, Patient Fairness will identify questions or concerns to raise to the provider that may be cause to reduce or eliminate what you owe, and will create a Letter of Dispute at your direction that it will mail to the billing provider.  The Letter of Dispute will also include a date for the billing provider to respond.

Much of the timing after the Letter of Dispute is mailed is dependent upon how quickly the provider responds.  Regardless, you have disputed the medical bill even if the provider does not respond or is not timely in doing so.  Reaching a formal agreement between you and the provider to settle a medical bill is also dependent on how quickly you and the provider exchange correspondence, and to what extent the parties are able to agree on common terms.

No.  Patient Fairness respects the privacy of our customers.  We do not sell customers’ personally identifiable information.  View our full privacy policy  here.

Patient Fairness is designed to be a low-cost option for persons to address problem medical bills themselves.  Through Patient Fairness persons can access tools and insights to deal directly with medical providers in questioning and challenging problem medical bills.  Patient Fairness charges low, fixed fees for these services.

Medical billing advocates or attorneys typically charge hourly rates and/or a percentage of the amount saved from a medical bill.  These fees are usually at least several hundreds of dollars, and can be tens of thousands of dollars if based on a percentage of savings from a high medical bill.  

Many persons desire to attempt to resolve problem medical bills on their own, before obtaining professional assistance,  Patient Fairness provides web-based self-help tools to assist with such efforts.

Patient Fairness's tools and information do not, and are not intended to, constitute legal advice and are not a substitute for the advice of an attorney.

Patient Fairness addresses each unique medical bill as a separate case.  This means that each medical bill from a distinct provider and date(s) of service requires its own case with Patient Fairness.  For example, if a hospital and surgeon have issued separate bills related to a patient’s appendectomy, each bill would require its own case with Patient Fairness.  Multiple issuances of the same medical bill, meaning the same distinct provider and date(s) of service, do not require separate cases.

Yes.  Patients are consumers, and they have rights and expectations to be treated fairly by physicians, hospitals and other medical providers.  Further, new laws such as the No Surprises Act now more formally recognize patients’ rights to fight unfair medical bills.

Consumers must take the initiative and make the effort to address situations in which they are not being given a fair deal in a transaction.  If the consumer does not stick up for him or herself then chances are that he or she will be stuck with an unfair deal.  Physicians and hospitals are sellers that look out for their own interests in billing patients.  Patients must look out for their own interests as consumers.

The average cost for a surprise medical bill for a patient with private insurance is $750 to $2,600.  Those costs can be far higher for persons without insurance, or for episodes more complex than the average.  Challenging unfair medical bills is financially smart, and can be critical to protecting your household’s budget, savings and credit.