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Your personalized letter looks like this...

March 19, 2026

RE: Dispute of Medical Bill — Account #XXXXX

Dear Billing Department,

I am writing to formally dispute charges on my recent medical bill dated 02/15/2026 in the amount of $4,827.00. After careful review, I have identified the following discrepancies:

1. Duplicate Charge — CPT 99213 (Office Visit)
This code appears twice on the statement. Per CMS guidelines, only one E/M code should be billed per encounter unless a separate, identifiable service was performed...

2. Upcoded Procedure — CPT 43239 vs 43235
The billed code (43239) represents an upper GI endoscopy with biopsy, however the operative notes indicate a diagnostic endoscopy (43235) was performed...

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