Dear Billing Department,
I am formally disputing the following charges on the above-referenced account:
- ER visit billed at highest tier — $3,420. The documented presentation does not meet the criteria for that level. Please re-code to the level that matches the visit.
- Duplicate basic blood-work charge — $340. The same line item appears twice on the same date. Please remove the duplicate.
- IV saline at significant markup — $268. Far above standard reimbursement. Please adjust to a fair rate.
Per the Fair Debt Collection Practices Act, please do not refer this account to collections while this dispute is pending. I expect a corrected statement within 30 days.