Script: negotiating a medical bill by phone.
Call the billing office with this script in front of you. It takes you through the order that works: check the charges, ask for financial assistance, ask for a discount, then make an offer and get it in writing.
Last updated .
When to use it
- You have a hospital or doctor's bill you cannot pay in full.
- You have the itemized bill and want to question charges.
- You want a discount or a payment plan before the bill goes to collections.
The script
Highlighted words in brackets are blanks. Replace each one with your own details.
Before you call: have the bill, the itemized bill, your insurance card and a pen ready. Write down the date, the time and the name of each person you speak with.
1. Start the call "Hello, my name is [Your full name]. I'm calling about account [Account number on the bill], for care on [Date of service]. Can I have your name, please?"
2. Check the charges "I've gone through the itemized bill and I have questions about some charges. Can you tell me what this charge is for: [The charge you are asking about]?" "This charge appears twice. Can you remove the duplicate and send me a corrected bill?" "My insurance should have covered this. Can you check that the claim went to my plan and was processed correctly?"
3. Ask for financial assistance "I can't pay this balance. Do you have a financial assistance program? Please send me the policy and the application." "While I apply, can you put a hold on my account so it doesn't go to collections?"
4. Ask for a discount "Is there a discount for patients who pay on their own, or for paying part of the balance today?"
5. Make an offer "I can pay [Amount you can pay at once] now as payment in full. Can you accept that and confirm it in writing?" "If that isn't possible, I can pay [Amount you can pay each month] a month. Can we set up a plan with no interest?"
6. If the answer is no "I understand. Who else can look at this? I'd like to speak with a supervisor or a patient financial counselor."
7. Before you hang up "Can you send me a letter or email that confirms what we agreed, with the new balance and the account number? I'll wait for it before I pay."
How to use it
- Get the itemized bill first. You can only question charges you can see. Use our itemized bill request letter if you do not have it yet.
- Call the number on the bill. Ask for the billing office or patient financial services. Say who you are and give the account number before anything else.
- Follow the order. Mistakes come off first. Then ask about financial assistance: at a nonprofit hospital, a patient who qualifies may not be charged more than the amounts generally billed to insured patients for emergency or medically necessary care Source 1. Ask for a discount and make your offer last.
- Offer only what you can really pay. A plan you cannot keep can send the account to collections later. Ask whether the plan charges interest.
- Write everything down. Note the date, the name of each person and what they agreed to. Ask for a supervisor if the first person cannot help.
It is worth the call. In a national survey of insured working-age adults, 38% (Commonwealth Fund, Gupta et al., April 18 to July 31, 2023) of those who challenged a bill for care they thought should have been covered got it reduced or removed.
What happens next
Do not pay a new amount until you have it in writing. The letter or email should give the new balance, the payment terms and the account number. Check the next statement to make sure the change was made.
If the billing office says no, put your request in writing with our hardship letter, and apply for financial assistance with our cover letter. Our guide to negotiating a medical bill covers insurance appeals, surprise bills and collectors.
Next step
If you need help with your own situation, these can help:
Sources
Note 1 IRS, "Limitation on Charges - Section 501(r)(5)". Published July 3, 2026. Last checked November 2, 2026.
Note 2 Commonwealth Fund, Gupta et al., "Unforeseen Health Care Bills and Coverage Denials by Health Insurers in the U.S.". Published August 1, 2024. Last checked November 2, 2026.
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