Overcharged Bill Complaint Letter [Sample]

[Your Name]
[Your Address]
[City, State, Zip Code]
[Your Bill or ID Number]

[DATE]

[Hospital or Doctor’s Name]
[Billing Department]
[Hospital or Doctor’s Address]
[City, State, Zip Code]

Dear [Name of Billing Officer]:

This letter is to formally inform you that the bill you gave me has overcharged for treatment in your hospital on [DATE]. 

I received treatment for a broken arm after an automobile accident on that day. Technicians took x-rays and set my arm, at which time I was discharged. The bill you gave me lists an MRI scan for the cost of [AMOUNT], which I didn’t have.

I have included a copy of the bill with the MRI cost highlighted. I have also included the record of treatment given to me when I was discharged. 

As you can see, I did not receive an MRI scan. Based on this information, I request that you send me a new bill that excludes the cost of an MRI scan. 

I have sent this request within the 30 day limit according to the instructions given to me by you for billing disputes. 

I hope to hear from you within two weeks from the date you receive this letter. I can be reached at [555-123-4567] or at [name@email.com].

Thank you for you quick attention to this matter.

Sincerely,

[Signature]
[Your Name]
[Your Billing or Treatment Number]
List of Enclosures