Dispute a billing error on a Montefiore Medical Center bill

Where to send a dispute letter

What to look for at Montefiore Medical Center

Based on the size and service mix of facilities like Montefiore Medical Center, the errors that most often surface on these bills are:

• ER Level Upcoding (99281–99285)

  ER visit billed at a higher acuity level than the documented presentation supports.

  Rule cited: CPT Evaluation & Management coding guidelines (AMA); CMS 42 CFR § 410.32

• No Surprises Act Violations

  Out-of-network provider billing more than in-network cost-share at an in-network facility.

  Rule cited: No Surprises Act — 42 U.S.C. § 300gg-111 (Pub. L. 116-260)

• Inflated Facility Fees

  A "facility fee" that exceeds the published standard charge for the service.

  Rule cited: Hospital Price Transparency Rule — 42 CFR § 180

• Unbundled CPT Codes (NCCI Violations)

  Components of a single bundled procedure billed as separate line items.

  Rule cited: CMS National Correct Coding Initiative — 42 CFR § 414.40

Find Montefiore Medical Center's price file

Since January 2021, federal regulation 42 CFR § 180 requires every US hospital to publish a machine-readable file of standard charges for all items and services. Montefiore Medical Center maintains this file — it is typically linked from the hospital's billing or “Price Transparency” page. You have the right under § 180.60 to a plain-language summary upon request.

If a line item on your Montefiore Medical Center bill exceeds the published standard charge, that is the single strongest dispute point under the transparency rule — the hospital cannot charge above its own published rate without producing a documented exception.

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