The BillFix Guide — straight answers about medical bills
Written from real cases. What’s true, what depends, and what to do next.
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Ambulance bills
Does the No Surprises Act cover ambulance bills?
Only partly. The federal No Surprises Act protects you from surprise bills for air ambulances, but ground ambulances were left out of the law. Whether you're protected from a ground ambulance balance bill depends on…
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Denials & appeals
My insurance approved my surgery, then denied it afterward. Can they do that?
Sometimes, yes — a prior authorization is not the same as a guarantee of payment, and insurers say so in the approval letter itself. But a retroactive denial of an already-authorized service is one of the most…
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Uninsured & self-pay
I'm uninsured and got a huge ER bill. Can it be reduced?
Very often, yes — sometimes to zero. Nonprofit hospitals are legally required to have financial assistance (charity care) policies, and uninsured patients with low or no income frequently qualify for large reductions or…
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Lab bills
Can I switch a lab bill to self-pay after insurance denied it?
Often, yes — and for genetic testing especially, the difference is dramatic. Lab list prices billed to insurance can be 10–20x higher than the same lab's self-pay rate. If insurance denied the claim and paid nothing…
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How we check
My bill is way above the Medicare rate. Is that an overcharge?
Usually not, on its own. Medicare's published rate is the only price list that's public and consistent, so it's what almost everyone benchmarks against — including us. But commercial insurers pay well above it and hospitals list higher…
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Coding errors
The diagnosis code on my claim is wrong — who fixes it?
The doctor who ordered the service. Diagnosis codes come from the ordering provider's documentation, so neither your insurance company nor the lab can change them — and calling your insurer to "fix a code" they didn't…
The Guide is general information, not legal or medical advice. Insurance rules vary by plan and state, and details change — check the dates on anything state-specific.