Frequently asked questions

An itemized bill lists each service and supply on its own line, with its billing code, date, units and charge.

If you have Medicare, federal law lets you send a written request to a physician, provider or supplier for an itemized statement of the Medicare items and services you received. It says the statement must be furnished within 30 days of your request, and sets a civil money penalty of up to $100 for each knowing failure to do so.

If you do not have Medicare, we did not find an official page we could cite that sets this right, so we do not claim one. You can still ask your provider or insurer for an itemized bill.

An explanation of benefits (EOB) is a summary that your health plan may send after you get care. CMS says plainly that it is not a bill.

It shows what your provider is charging the plan and the amount the plan will cover. If the plan does not cover the whole cost, the provider may send you a separate bill, unless the law prohibits it.

The allowed amount is the most your plan will pay for a covered item or service. It is generally the basis for working out your share of the cost.

CMS's examples show it can be lower than what the provider billed the plan.

If you have coverage and get care from an out-of-network provider, your plan might not cover the whole cost. The provider could then ask you to pay the difference between its charge and what your plan covers. CMS calls this a balance bill or a surprise bill.

CMS says the federal No Surprises Act prohibits surprise billing in some circumstances. The page we cite does not list them, so we do not try to say which ones.

A Good Faith Estimate is a list of expected charges, given before you get care.

CMS says that in most cases providers and facilities must give you one when you schedule care at least 3 business days ahead, or if you ask for one. It is meant for people who do not have or are not using health insurance.

CMS describes a federal dispute process for people who did not have or did not use insurance and told the provider so before getting care. It applies when a provider charged at least $400 more than its Good Faith Estimate.

You need an initial bill dated within the last 120 calendar days, and there is a $25 non-refundable administrative fee.

CMS words the time limit slightly differently on different pages, so confirm your date with CMS before you rely on it. You can compare your own numbers on our estimate tool.

California's Hospital Fair Billing Program is run by HCAI. Its page says that AB 1020 raised the income level for financial assistance from 350 percent to 400 percent of the federal poverty level.

Whether you qualify, and whether care is free or discounted, depends on the hospital's own financial assistance policy, which you can ask the billing office for. We could not confirm more detail from the official pages, so we do not state any.

CMS defines an MUE as the maximum units of service reported for a code on the vast majority of appropriately reported claims, by the same provider for the same patient on the same date of service.

Not every code has one, and CMS keeps some values confidential. When the units on a bill are above a published value, Unbundle shows it as a question to ask, not as proof of an error.

A PTP edit is a pair of codes that CMS says should not be reported together. For the same patient on the same date, CMS says the first code of the pair (Column One) is eligible for payment and the second (Column Two) is denied, unless a clinically appropriate modifier is reported.

“Possible unbundling” is our name for two lines on your bill that match one of these edits. It is not a CMS term.

It is a question to ask the billing office, not a finding that anyone did something wrong.

No. The AI reads your bill into structured data. Fixed, tested rules decide every finding, using public Medicare data, and the AI cannot add, remove or change a finding or its amount.

Separately, if you open “What is this?” on a line, the AI gives a general definition of that billing code. It does not explain or decide your findings.

Findings are things worth asking about, not certain mistakes. One check compares prices with Medicare, and the 5 times threshold it uses is our own choice, not a legal standard.

Your files are stored in a private folder that only your account can read, write or delete.

Your files are sent to Anthropic's API so your bill can be read. The only other thing sent is a single billing code, and only if you open “What is this?” on a line. If you type your bill in instead of uploading it, nothing you type is sent to Anthropic, apart from that same billing code. Anthropic's published terms say that, by default, your bills aren't used to train its models and API data is deleted within 30 days. Those are Anthropic's terms, not ours.

Deleting a bill removes the bill, its line items and the uploaded files from our storage.

We never sell your information.

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