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Fair Bill

Sample bill — fictional data for demonstration. Your real data never leaves your device.

Demo · Sample bill

See Fair Bill work on a sample bill

This is a fictional bill from a fictional hospital. The duplicate detection, poverty-level math, and letter generation are the real tool running on made-up numbers.

Sample provider: Sample General Hospital (fictional)

1. The sample bill

Six itemized lines. One row is repeated — same description, same amount — so the duplicate check has something real to find.

  • Emergency dept visit (Level 4)

    $2,480

  • CT scan abdomen w/ contrast

    Duplicate

    $3,150

  • CT scan abdomen w/ contrast

    Duplicate

    $3,150

  • Pharmacy

    $312

  • Facility fee

    $1,940

  • Lab panel, comprehensive metabolic

    $184

  • Billed total

    $11,216

2. What the check found

One duplicate charge flagged. That's a line the tool will ask the provider to confirm or remove.

3. Does the sample household qualify?

Sample household of 2 with annual income $65,000. Compared to the federal poverty level for that household size ($21,640), that's 300% of FPL.

Under California's Hospital Fair Pricing Act, a nonprofit hospital must offer free or discounted care up to 400% of the federal poverty level. This household lands at 300% — inside the free / charity-care band.

4. The letters this produces

Two letters, generated in the browser from the same data. Bracketed fields are what the real user would fill in.

Subject

Disputed charges on account [ACCOUNT OR BILL NUMBER]

[TODAY'S DATE]

To the billing department at Sample General Hospital (fictional),

Re: account [ACCOUNT OR BILL NUMBER] · date of service [DATE OF SERVICE] · patient [YOUR FULL NAME]

I've reviewed the bill for the account above and I'm writing to dispute specific charges. Please pause collections on this account while you investigate; California law prohibits adverse credit reporting on medical debt, and I'm asking for written confirmation that no further collection activity will occur until this is resolved.

Duplicate charges.

The following line(s) appear more than once on the bill with the same description and amount. Please confirm in writing whether each is a separate, distinct service, or remove the duplicate(s) from the balance:

• CT scan abdomen w/ contrast — $3,150.00

Please send a written response, including a corrected statement, within 30 days. If you need a copy of my insurance card or any other information to investigate, write to me at the address above.

Thank you.

[YOUR FULL NAME] [YOUR MAILING ADDRESS]

Highlighted fields are yours to fill in.

That's the whole tool.

The demo used fictional numbers. On your own bill, everything you enter stays on your device.

Check your own bill