BillStand

Our methodology and sources

Everything BillStand publishes and every letter it generates is built on primary sources — federal statutes, IRS regulations and government datasets — not on other people's blog posts. This page explains exactly how, and lists every source so you can check us.

How a guide is written

  1. Start from the primary source. Before anything is written, we read the governing text itself — the statute, the IRS regulation, the CMS dataset documentation. Secondary summaries are used to find the source, never as the source.
  2. Answer the question in the first sixty words. Every guide opens with a direct short answer before any context. People arriving with a bill in their hand deserve the answer immediately, and it happens to be the format both search engines and AI assistants extract.
  3. State what varies. Where an answer genuinely depends on your state, your insurer or how a debt is classified, we say so explicitly rather than papering over it with a national average.
  4. Cite the rule by name and number. "Federal law protects you" is useless. "15 U.S.C. § 1692g gives you the right to demand written validation" is something you can look up, and something a billing department recognises.
  5. Review and date. Every guide carries a last-reviewed date on the page. When a rule or dataset changes, the guide is revised and the date moves.

How a letter is generated and checked

Your answers determine which of six strategies applies — a self-pay or uninsured reduction, a financial assistance request under 501(r), a debt validation demand under the FDCPA, a billing error dispute, an insurance or surprise-billing review, or an escalation when a first letter went unanswered. The strategy decides which protections the letter invokes and who it is addressed to.

The letter is then drafted by a large language model working from a tightly constrained instruction set, and it passes an automated compliance check before you ever see it. That check rejects any draft that promises an outcome, claims a specific reduction, asserts a legal conclusion, threatens action we would not take, or cites a state law we cannot verify. If the model is unavailable or its draft fails the check, the system falls back to a reviewed template. A letter you receive has passed the same checks either way.

One deliberate design decision: our letters cite federal protections, which apply identically in all 52 U.S. jurisdictions, plus a single neutral request that any additional protections your state provides be applied as well. We do not assert specific state statutes, because a fifty-state table of medical billing law cannot be kept accurate and a wrong citation in your letter would hurt you, not us.

How our data pages are built

Our hospital directory and bill code lookup are generated directly from federal datasets, not written by hand and not assembled from other directories. Each page names the dataset it came from and its publication date.

Two rules govern them. First, we publish only what the data actually says. Where the government does not publish a hospital's specific financial assistance income threshold, we do not guess at one — we explain what federal law requires that hospital to offer and exactly how to obtain its actual policy. Second, we distinguish a legal obligation from a courtesy. Section 501(r) binds nonprofit hospitals; a for-profit hospital may still have an assistance program, but it is not federally required to, and our pages say which situation you are in.

On the pricing pages, the figures are what Medicare data shows a hospital billed versus what it was actually paid. That is a real, citable benchmark and a useful one — but it reflects Medicare patients in the data year shown, not what you personally will be charged. We label it that way on every page.

What we will not do to rank

This site is designed to be found, and we are not coy about that. But there are things we will not do to be found: invent testimonials or results, publish a state-by-state legal table we cannot verify, republish copyrighted code descriptions we are not licensed to use, generate thousands of near-identical pages with no real information on them, or write scare-first content that treats a frightened person as a conversion opportunity.

If a page on this site is not useful to someone holding a bill, it should not exist.

Our sources

Every one of these is a primary source, freely available, and linked directly. If you want to verify something we have written, start here.

  • Fair Debt Collection Practices Act (FDCPA)

    15 U.S.C. § 1692 et seq. · Cornell Law School, Legal Information Institute

    Governs third-party debt collectors. Section 1692g gives you the right to demand written validation of a debt, and collection activity should pause until the collector provides it.

  • Section 501(r) of the Internal Revenue Code

    26 U.S.C. § 501(r); 26 CFR § 1.501(r)-1 to -7 · Internal Revenue Service

    Requires every 501(c)(3) nonprofit hospital to maintain and widely publicize a written financial assistance policy, to limit what it charges eligible patients to the amounts generally billed to insured patients, and to hold off on extraordinary collection actions for at least 120 days after the first post-discharge bill.

  • No Surprises Act

    Public Health Service Act §§ 2799A-1 to 2799A-2, effective 2022 · Centers for Medicare & Medicaid Services

    Protects patients from many surprise out-of-network bills, including most emergency care and out-of-network clinicians working at in-network facilities, and creates the right to a good faith estimate for self-pay patients.

  • HHS Poverty Guidelines

    Published annually in the Federal Register by the Department of Health and Human Services · HHS Office of the Assistant Secretary for Planning and Evaluation

    The income figures nearly every hospital financial assistance policy is written against — typically expressed as a multiple such as 200%, 300% or 400% of the guideline for your household size.

  • CMS Hospital General Information

    Dataset xubh-q36u, Provider Data Catalog · Centers for Medicare & Medicaid Services

    The federal registry of U.S. hospitals — legal name, address, phone, facility type, ownership and emergency services. It is the backbone of our hospital directory.

  • Medicare Inpatient Hospitals — by Provider and Service

    CMS Medicare Provider Utilization and Payment Data, inpatient · Centers for Medicare & Medicaid Services

    What each hospital billed Medicare and what Medicare actually paid, by diagnosis-related group. This is the gap between the sticker price and the real price, published by the government, hospital by hospital.

  • MS-DRG definitions (IPPS Final Rule, Table 5)

    Medicare Severity Diagnosis-Related Groups, published annually by CMS · Centers for Medicare & Medicaid Services

    The official code list behind inpatient hospital billing — the codes that appear on your bill and what each one means.

  • NPPES National Provider Identifier registry

    National Plan and Provider Enumeration System · Centers for Medicare & Medicaid Services

    Used by our provider lookup to confirm you are addressing your letter to a real, federally registered provider at its registered address.

Mentions of CPT codes throughout this site are descriptive only. CPT is a registered trademark of the American Medical Association and its code descriptions are copyrighted by the AMA; we do not reproduce them. Our code pages cover MS-DRG codes, which are published by the Centers for Medicare & Medicaid Services and are in the public domain.