Medical Bill Review & Error Estimator
Analyze your medical bill for potential errors and overcharges using industry-standard error rate data. Enter your bill details below to estimate how much you may be owed back.
Formula
Adjusted Error Probability = min( BaseErrorRate(serviceType) × InsuranceAdj × ReviewFactor + LineItemBonus, 99% )
Statistical Overcharge Estimate = TotalBill × AdjustedErrorProbability × OverchargeRate(serviceType) × ReviewFactor
Suspected Error Recovery = (DuplicateCharges + UnbundledCharges) × 0.90
Total Recoverable = min( StatisticalOvercharge + SuspectedErrorRecovery, TotalBill )
Where: InsuranceAdj = 1.05 (insured) or 0.95 (self-pay); ReviewFactor = 1.0 (not reviewed), 0.65 (partial), 0.30 (fully reviewed); LineItemBonus = min( max(LineItems − 10, 0) × 0.003, 0.15 )
Assumptions & References
- Medical Billing Advocates of America (MBAA): Up to 80% of medical bills contain at least one error.
- NerdWallet Health / Becker's Hospital Review: Average overcharge on erroneous bills is approximately 25–30% of the total bill.
- GAO Report (2020): Inpatient hospital billing has the highest error and upcoding rates among all service types.
- Duplicate charges are assumed to be recoverable at 90% confidence when user-identified.
- Unbundled charges (billing separately for procedures that should be combined) are assumed recoverable at 90% confidence.
- Insurance adjustment reflects that insured bills involve more complex CPT coding, increasing error likelihood slightly.
- This tool provides estimates only and does not constitute legal or medical billing advice. Consult a certified medical billing advocate for formal review.
- Error rates vary by provider, region, and payer. Actual recoverable amounts may differ significantly.