These are the patterns we look for. Every finding cites the specific line on your bill it came from.
DUPLICATE CHARGES
Same procedure billed twice
The same CPT code charged on two separate lines for the same visit. Most common bleed. We cross-match by code, amount, and date.
$200 – $2,400
NSA VIOLATIONS
Out-of-network billed in-network
Emergency rooms, anesthesiologists, and radiologists are often out-of-network even at in-network hospitals. Federal No Surprises Act caps your responsibility at the in-network rate.
$500 – $5,000
MATH ERRORS
Adjustments that don't add up
Charged minus insurance adjustment minus payment ≠ what they're billing you. When the math is off, it's almost always in the hospital's favor.
$50 – $3,000
LUMP-SUM PHARMACY
Unitemized $1,000+ pharmacy charges
A single line item like 'Pharmacy: $1,892' with no breakdown of what was actually given. You have a legal right to itemization — and once you see it, half the items often don't survive scrutiny.
$200 – $1,500
UPCODING
Visits coded at the highest complexity
A routine sprained ankle visit billed at ER complexity level 5. Hospitals routinely code the highest defensible level. We flag patterns that don't match the documented care.
$100 – $800
UNBUNDLING
Procedures billed in pieces instead of bundled
Surgery + anesthesia + facility fee + supplies all billed separately when the procedure has a global CPT that includes them. Most common on surgical bills.
$500 – $10,000