Prompt details

Tested on

Claude Opus 5.5

Length

608 words · 3 fill-ins

Example input

[Itemized bill]: Riverside Regional Medical Center. Patient account ending 5520. Date of service: Day 1 (emergency department visit). Line | Rev code | CPT/HCPCS | Description | Qty | Charge 1 | 0450 | 99285 | ED visit, high complexity | 1 | $3,100.00 2 | 0350 | 70450 | CT head/brain w/o contrast | 1 | $1,450.00 3 | 0350 | 70450 | CT head/brain w/o contrast | 1 | $1,450.00 4 | 0301 | 80053 | Comprehensive metabolic panel | 1 | $310.00 5 | 0305 | 85025 | CBC with differential | 1 | $145.00 6 | 0300 | 36415 | Venipuncture | 1 | $55.00 7 | 0730 | 93005 | ECG tracing | 1 | $380.00 8 | 0260 | 96374 | IV push, single drug | 1 | $420.00 9 | 0636 | J2405 | Ondansetron injection, per 1 mg | 4 | $95.00 10 | 0270 | (none) | Med/surg supplies, general | 1 | $995.00 Total charges: $8,400.00 Insurance payments: -$1,800.00 Adjustments: -$3,050.00 Patient balance due: $3,550.00

[Explanation of benefits]: Clearpath Health Plan. Explanation of Benefits. This is not a bill. Provider: Riverside Regional Medical Center (in network). Date of service: Day 1. Service | Billed | Allowed | Notes 99285 ED visit | $3,100.00 | $2,500.00 | 70450 CT head | $1,450.00 | $930.00 | 70450 CT head | $1,450.00 | $0.00 | D18: Duplicate of a service already processed on this claim. 80053 | $310.00 | $120.00 | 85025 | $145.00 | $45.00 | 36415 | $55.00 | $20.00 | 93005 | $380.00 | $90.00 | 96374 | $420.00 | $180.00 | J2405 | $95.00 | $15.00 | Supplies (no code) | $995.00 | $0.00 | P44: Included in facility payment. Not billable to member. Claim totals: Billed $8,400.00. Allowed $3,900.00. Plan paid $1,800.00. Deductible $1,500.00. Coinsurance (25%) $600.00. Amount you may owe the provider: $2,100.00

[Your situation]: I went to the Riverside Regional emergency department after a fall at home and was there about 3 hours. I remember having one CT scan of my head, not two. I was sent home the same night. The hospital is a nonprofit in Ohio and was in network with my plan. The bill came 6 weeks after the visit, and a second notice says the balance is due within 30 days. It is not in collections. My household is 3 people (me, my spouse and our 9-year-old) with a combined income of about $58,000 a year. I can pay about $150 a month. I have not called the hospital yet.

Example output

Medical Bill Review: Riverside Regional Medical Center, Account Ending 5520

Assumptions:

I take Riverside's in-network contract with Clearpath to bar billing you above the EOB's patient responsibility. Confirm this with Clearpath.
The 2025 federal poverty guideline for a household of 3 is $26,650, so your $58,000 is about 218% of it. Check the current-year figure the hospital uses.

1. Line-Item Check

Line	Code	Description	Billed	EOB says	Flag	Question to ask
1	99285	ED visit, high complexity	$3,100.00	Allowed $2,500.00	None from these figures	None needed. You can ask for records if the level seems high for your visit.
2	70450	CT head w/o contrast	$1,450.00	Allowed $930.00	None	None
3	70450	CT head w/o contrast	$1,450.00	Allowed $0.00, D18: duplicate	Possible duplicate; care you recall not receiving	"Two CT lines on the same date. I recall one scan. Please confirm whether two were done, and remove line 3 if not."
4	80053	Comprehensive metabolic panel	$310.00	Allowed $120.00	None	None
5	85025	CBC with differential	$145.00	Allowed $45.00	None	None
6	36415	Venipuncture	$55.00	Allowed $20.00	None	None
7	93005	ECG tracing	$380.00	Allowed $90.00	None	None
8	96374	IV push, single drug	$420.00	Allowed $180.00	None	None
9	J2405	Ondansetron, per 1 mg ×4	$95.00	Allowed $15.00	None	None. 4 units = 4 mg, which matches the unit description.
10	(none)	Med/surg supplies, general	$995.00	Allowed $0.00, P44: not billable to member	No code; insurer marked not billable to you	"Please send an itemized list of these supplies with codes, and confirm this charge is not part of my balance."

The gap: The hospital bills you $3,550.00, but the EOB says you may owe $2,100.00, a gap of $1,450.00.

Claude Opus 5.5

Dispute a Medical Bill – Medical bill dispute prompt for ChatGPT and Claude

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Claude Opus 5.5

This prompt checks a US medical bill line by line against your insurer's explanation of benefits. Paste both and your situation; you get the flagged lines, what you may owe, the letters and a call script.

What you get

A line-by-line check of the bill against your EOB, with a question for every flag
What you may owe in the best and worst case, and what to pay now
A dispute letter and a financial assistance request, ready to send
A phone script with a notes log, and when to bring in your insurer or an advocate

How to use it

1
Get the itemized bill and the EOB
Ask the billing office for the itemized bill with codes, and download the EOB for the same date of service from your insurer's site.
2
Read the line-item check
Confirm each flag against what you remember of the visit, such as how many scans you had, before you send anything.
3
Call, send, then log
Call first with the script, send the letters the same week, and record the name and reference number from every call.

Better results

Ask for the hospital's financial assistance policy even if you think you earn too much. Policies differ, and some cover more households than people expect.
Before you call, send a follow-up: "Turn the dispute letter into three sentences I can read to the billing office."
If a line is for care you did not get, ask your insurer to reprocess the claim as well, so the EOB and the bill stay in step.

Questions

Can ChatGPT help with a medical bill?

Yes. ChatGPT, Claude or Gemini can compare an itemized medical bill with your explanation of benefits, flag duplicate or denied lines and write dispute and financial assistance letters. It cannot see the hospital's contract or your records, so treat each flag as a question to confirm.

How do I dispute a medical bill?

Ask for an itemized bill with codes, compare it with your explanation of benefits, then call and write to the billing office about each line you question. Ask them to hold the account from collections while they review it, and keep a log of every call.

Can AI negotiate a hospital bill?

AI can prepare the negotiation: the errors to raise, a financial assistance request, a discount or payment plan offer and a phone script. You still make the call and send the letters, and the hospital decides. No prompt can promise a reduction.

Do nonprofit hospitals have to offer financial assistance?

Yes. Under IRS rules, nonprofit hospitals must have a written financial assistance policy and accept applications for at least 240 days after the first bill sent after discharge. Who qualifies and how much is forgiven differ by hospital and state, so ask for the policy.

Updated 8 Nov 2026