Know what your medical bill should cost
OrbDoc Bill Analyzer checks your medical bills against Medicare rates and CMS rules. Find errors. Understand charges. Get answers in seconds.
Your data stays on your device. Always.
You should know
Americans spend billions each year due to preventable billing mistakes. Always request an itemized bill with codes, then review using the checklist below.
- • Get a detailed, itemized bill (CPT/HCPCS with modifiers)
- • Match services received to what’s billed
- • Verify code levels are appropriate for the visit
- • Check for duplicates / global vs split double bills
What Bill Analyzer checks
Medicare benchmarks
See what Medicare pays for every procedure on your bill. If you're being charged 500% more, you'll know.
Coding errors
We check 3.3 million NCCI code pair rules. When two procedures shouldn't be billed together, we flag it.
Quantity limits
CMS publishes maximum units per day for thousands of procedures. We check if your bill exceeds them.
Drug pricing
For medications (J-codes), we compare against published average sales prices.
Technical coverage
| What we check | Coverage |
|---|---|
| NCCI bundling rules | 3.3 million code pairs |
| Medicare fee schedule (PFS) | 18,866 procedure codes with locality adjustments |
| Quantity limits (MUE) | 13,800 thresholds |
| Inpatient pricing (DRG) | 700+ groups with state wage indices |
| Drug pricing (J-codes) | 1,000+ medications |
Understanding Your Options
When You Have Leverage
- Balance billing: Provider charged more than EOB amount (contract violation for in-network providers)
- You're uninsured: Self-pay rates are negotiable before or after service
- Billing errors: Duplicate charges, wrong codes, services not rendered
- Financial hardship: Apply for charity care (income-based, requires documentation)
When You Don't Have Leverage
- Insurance processed claim: Provider legally bound by contracted rates
- Charges match EOB: "Patient responsibility" is non-negotiable
- High deductible plans: You owe 100% until deductible met
- Legitimate charges: Services rendered correctly, coding is accurate
Key Insight: Why Negotiation Fails After Insurance Processing
Once your insurance processes a claim at contracted rates, providers cannot arbitrarily discount your portion without violating their contract with the insurance company.
What actually works: Apply for financial assistance (charity care) through the hospital's formal program. This is income-based, requires documentation (pay stubs, tax returns), and doesn't violate insurance contracts.
Have a photo or PDF of your bill? Upload it above and we'll automatically extract the codes for you.
Upload bill →For Healthcare Providers
If you're a provider managing billing complexity, OrbDoc helps you document accurately for proper coding, avoid denials, and optimize revenue.
Medicare Billing Optimization
Capture AWV, TCM, CCM, RPM revenue with accurate documentation.
Audit Defense & Compliance
Generate audit defense packages in 60 seconds with evidence-linked documentation.
How Evidence-Linking Works
Technical deep-dive into claim-level audio timestamps for audit defense.
What to do next
Found a pricing discrepancy? Here are your next steps to negotiate, appeal, or understand what went wrong.
How to analyze your medical bill in 3 steps
- Add codes Enter 5-digit CPT/HCPCS codes
- Select insurance Medicare, Medicaid, Commercial
- Review results See cost ranges & red flags
Frequently asked questions
No. The analyzer runs fully in your browser and does not collect or store PHI.
No. This is an educational tool to help you ask better questions.
Ranges are derived from public sources (e.g., Medicare fee schedule) and are estimates that vary by locality and plan.
CPT stands for Current Procedural Terminology. CPT codes are 5-digit numbers that identify medical services and procedures billed to insurance.
Compare charges to typical cost ranges, check for duplicate codes, verify insurance coverage, and review your Explanation of Benefits (EOB). The analyzer flags common issues like unbundling and unusual cost combinations.
Contact your provider's billing department first. Ask about specific codes, request an itemized bill, and verify insurance processing. If issues persist, contact your insurance company or seek patient advocacy help.
Yes. Many providers offer payment plans, financial assistance, or discounts for uninsured or high-deductible patients. Ask early and be persistent. Some hospitals have charity care programs.
CPT codes are 5-digit numbers for medical services. HCPCS codes (Healthcare Common Procedure Coding System) include CPT codes plus additional codes for supplies, drugs, and services not in CPT (often start with letters).
Common reasons include: missing documentation, services not medically necessary, bundling rules, prior authorization required, or coverage limitations. Ask your provider to resubmit with additional documentation.
For providers: Evidence-linking technology generates audit defense packages in 60 seconds; total response time 90-120 minutes with claim-level audio proof.
Modifiers are 2-digit codes added to CPT codes to indicate special circumstances, like -25 (significant separate E/M service) or -59 (distinct procedural service). They affect how codes are processed and reimbursed.
An EOB shows what your insurance covered, what you owe, and why. Compare it to your bill: the charges, allowed amounts, your share (deductible/coinsurance), and any denials or adjustments.
Balance billing occurs when a provider bills you for the difference between their charge and what insurance paid. For in-network providers, this is usually prohibited beyond your deductible/coinsurance.
Timelines vary by state and provider. Typically 30-90 days. Medical bills generally don't affect credit immediately, but collections can. Contact providers early to arrange payment plans if needed.
Common hospital bill line items explained
Facility technical charge vs. physician interpretation. You should not see a global code billed together with split professional/technical components for the same study.
Global (93000) vs. split billing (93005 technical, 93010 professional). Global and split together is typically a double bill.
Facility level charge + separate professional fee for the clinician. Verify the level matches documentation.
In‑network preventive services are often $0 cost‑share in outpatient settings. If you were billed, ask if recoding applies.
Hospital/ED medication billing uses HCPCS (J‑codes) and differs from retail pharmacy. Confirm the medication was administered and billed correctly.