Records and bill request builder
Build requests for your medical records and an itemized bill.
- Private: nothing leaves this tab
- General information, not legal advice
What it asks, and what it is not
What it asks. Who holds the records, the dates of care, and what you need.
Everything you type stays in this browser tab. Nothing is sent anywhere, and no account is needed.
What it is not. It writes requests for you to review and send. It does not send them.
What do you need?
Choose one above and the letter appears here.
- Private: nothing leaves this tab
- General information, not legal advice
What it asks, and what it is not
What it asks. Who holds the records, the dates of care, and what you need.
Everything you type stays in this browser tab. Nothing is sent anywhere, and no account is needed.
What it is not. It writes requests for you to review and send. It does not send them.
Related guides and checklists
- Guide
How to ask for an itemized bill and check it
Ask the provider for every charge on your account, then compare it with your Explanation of Benefits to find errors. Covers the billing-records right you do have and the itemized-bill right the federal rules do not give.
- Guide
How to get your medical records
Ask your doctor, hospital or clinic in writing for a copy of your own records for your appeal. Covers what the federal health privacy rule says about timing and fees, and which records an appeal needs.