IGOTCHU

Medical Bill Dispute Letter — Timely Billing Violation

[TODAY'S DATE]

Billing Department
Central Texas Medical Center
4100 Guadalupe Street
Austin, TX 78751

RE: Account [ACCOUNT NUMBER] — Formal Dispute, Timely Billing Violation & Financial Assistance Request

Dear Billing Department:

I am writing to formally dispute the $4,200 balance on the above-referenced account for services rendered approximately 14 months ago. I have only recently received this bill.

This balance is disputed on the following specific grounds:

1. TIMELY BILLING VIOLATION — TEXAS HEALTH & SAFETY CODE § 311.002
Texas Health & Safety Code § 311.002 requires hospitals to submit claims promptly. A 14-month delay in presenting this bill constitutes a material failure of timely billing obligations. I am requesting documentation showing the exact date this account was generated and the specific reason for the 14-month delay.

2. FINANCIAL ASSISTANCE — TEXAS HEALTH & SAFETY CODE § 311.0025
As a patient who lacked insurance coverage at the time of service, I am entitled to apply for your charity care and financial assistance program under Tex. Health & Safety Code § 311.0025 and applicable IRS requirements for tax-exempt hospitals (Form 990, Schedule H). Please provide your complete financial assistance policy and application form immediately.

3. CHARGEMASTER RATE — NO SURPRISES ACT (42 U.S.C. § 300gg-132)
The $4,200 charge reflects undiscounted chargemaster rates. Under the federal No Surprises Act and ACA provisions, uninsured patients are entitled to pay no more than the applicable Medicare or lowest negotiated rate. Medicare reimbursement for services of this type in Austin, TX is estimated at $840–$1,100. The $4,200 charge is 380–500% above this rate.

I demand the following in writing within 30 days:
  • Complete itemized statement of all charges by CPT code
  • Your financial assistance / charity care application and eligibility guidelines
  • Documentation showing when this account was generated and why billing was delayed
  • Your lowest negotiated rate for each CPT code billed

I am prepared to resolve this account promptly following receipt of the above. Until then, I dispute this balance in full and request that no collection activity be initiated or continued. If this account has been referred to collections, this letter constitutes a written dispute under the Fair Debt Collection Practices Act, 15 U.S.C. § 1692g.

Sincerely,

[YOUR NAME]
[YOUR STREET ADDRESS]
[AUSTIN, TX ZIP CODE]
[YOUR PHONE NUMBER]

14-Day Follow-Up — Central Texas Medical Center

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Escalation to Billing Director + Texas HHSC

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Call Script — Patient Financial Services

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Opening Ask

Demand full waiver of the $4,200 balance, citing the 14-month timely billing violation under Tex. Health & Safety Code § 311.002. Open at $0 owed.

Settlement Floor

Accept no more than $1,050 — the estimated Medicare equivalent rate for Austin, TX. A 14-month-late bill at chargemaster rates with lapsed insurance is legally indefensible.

Ask to Speak With

Patient Financial Services Manager — not a front-line billing rep. Only managers can approve waivers.

Best Time to Call

Tuesday or Wednesday, 10am–12pm. Avoid Mondays and the last week of the month.