README.md

templates/

Thirty-four ready-to-mail letter and complaint templates with placeholders that the LLM fills from the patient's actual bill and EOB evidence, covering every stage from itemized-bill request through ERISA appeal, state DOI complaint, HIPAA access demand, FCRA credit-report dispute, and small-claims civil warrant.

• attorney_intake_packet.md: Use when the patient has run the kit's dispute flow to a point where engaging counsel makes sense and needs a clean one-document summary to hand to an attorney for an intake consult.
• complaint_cms_hpt.md: For when a hospital has failed to publish a compliant machine-readable file (MRF) of standard charges under 45 CFR Part 180.
• complaint_emtala.md: For when a Medicare-participating hospital with a dedicated emergency department refused screening, refused stabilizing treatment, inappropriately transferred or discharged, or denied emergency care…
• complaint_hipaa_access.md: For when a healthcare provider has failed to provide a patient access to their own medical or billing records within 30 days of a written request, has charged a fee that exceeds reasonable cost-based…
• complaint_irs_form_13909.md: Use when a non-profit (501(c)(3)) hospital is engaging in conduct inconsistent with its charitable purpose: failing to honor its Financial Assistance Policy under IRS § 501(r), pursuing extraordinary…
• complaint_state_doi.md: Use to file a formal complaint with the patient's state insurance department or attorney general's consumer protection division.
• email_biller_eob_requested.md: Companion to letter_request_eob.md.
• encounter_combined_dispute.md: Use when a single care encounter generated bills from three or more separate providers (typical pattern: hospital facility + ER physician group + radiology + anesthesia + pathology + ambulance) and…
• letter_30day_warning.md: Use when an initial dispute letter has gone unanswered for 30+ days and the disputed amount is within the state's small-claims jurisdictional limit.
• letter_auto_med_pay.md: Use when a medical bill stems from a motor-vehicle accident and the patient needs to (a) force the auto insurer to apply med-pay/PIP coverage, (b) force a hospital to bill health insurance instead of…
• letter_challenge_hospital_lien.md: Use when the patient was injured (motor-vehicle, slip-and-fall, on-the-job, third-party tort) and the hospital that treated them has filed a statutory hospital lien against the patient's recovery…
• letter_credit_report_dispute_fcra.md: Use when the disputed medical bill has been reported to one or more credit bureaus and is appearing on the patient's credit report.
• letter_dental_dispute.md: Dental insurance billing has its own pathologies separate from medical insurance.
• letter_dispute_reply.md: Use when the patient sent the initial dispute letter, the provider or insurer replied, but the reply did not address the substance of the dispute.
• letter_erisa_502c_penalty.md: Use when the patient sent a written request for plan documents under ERISA § 104(b)(4) / 29 U.S.C.
• letter_fdcpa_validation.md: Use within 30 days of the first written contact from a third-party debt collector (or debt buyer) about a medical debt.
• letter_financial_assistance_application.md: For non-profit hospital bills, this letter triggers the hospital's obligation under IRS § 501(r) to consider you for financial assistance (charity care).
• letter_good_faith_estimate_request.md: Use when the patient is uninsured or self-pay and a scheduled service is at least three business days away, or when a bill has arrived for a self-pay service for which no GFE was offered.
• letter_ground_ambulance.md: Two distinct letters depending on whether the patient's state has a ground-ambulance balance-billing protection.
• letter_hardship_negotiation.md: Use when a bill is correctly coded for services you actually received, but the amount exceeds what you can pay.
• letter_initial_dispute.md: Use this after you have an itemized bill and have identified specific findings (price gouging, CPT mismatch, duplicate charges, services not received).
• letter_insurance_appeal_erisa.md: Use when an ERISA-covered employer health plan has denied a claim and you are filing the internal appeal (or the final-level appeal).
• letter_itemization_request.md: Use this letter as the first action against any non-itemized bill.
• letter_medicaid_appeal.md: Medicaid appeals are state-administered.
• letter_medicare_appeal.md: Use for a written Medicare appeal request at Level 1 (Redetermination for Parts A/B, Reconsideration for Part C, or Redetermination for Part D) or Level 2 (QIC for A/B, IRE for Part D).
• letter_negotiation_counter_offer.md: Use when the bill is for services the patient actually received, the EOB and itemization are both in hand, and the line-item charges are materially above fair market value.
• letter_no_surprises_violation.md: Use when a bill appears to violate the federal No Surprises Act.
• letter_ppdr_initiate.md: Use when the patient is uninsured or self-pay, received a Good Faith Estimate before the service (or should have under 45 CFR § 149.610), and the final bill for any single provider or facility…
• letter_records_request_hipaa.md: Use to obtain the patient's medical record under the federal right of access at 45 CFR § 164.524 (HIPAA Privacy Rule) before, during, or in support of a billing dispute.
• letter_request_eob.md: Use when a provider bill has arrived but the corresponding Explanation of Benefits (EOB) from the patient's health plan has not.
• letter_request_insurer_initiate_idr.md: Use when an out-of-network provider has billed a service that is governed by the federal No Surprises Act's balance-billing protections (emergency services under 42 U.S.C.
• letter_subrogation_response.md: Use when the patient's health insurance plan has asserted a subrogation or reimbursement claim against a tort recovery the patient is pursuing (motor-vehicle, slip-and-fall, premises liability…
• letter_wc_carrier_redirect.md: Use when the patient received a medical bill for an injury that arose out of and in the course of employment.
• small_claims_civil_warrant.md: Use after the dispute letter has gone unanswered, the 30-day warning has gone unanswered, and the patient is ready to file a civil action.