Duplicate charge letter for a medical bill (free template)

Updated October 1, 2026 · How we write our guides

When to use it

Use this letter when the same charge appears twice on an itemized bill and a call didn't fix it. It names both lines, says you got the care only once, and asks the provider to remove the extra line. It also asks for a corrected bill, a corrected claim if you have insurance, and a hold.

The same charge shows up twice on your bill, and you got the care only once. A call to the billing office didn't fix it. This letter asks the provider, in writing, to remove the extra line and send a corrected bill.

Before you send it, make sure the repeat isn't a correct one. Our guide to duplicate charges on a medical bill shows how to tell the difference.

When to use this letter

Use it when 2 lines on the same bill match on all 4 of these:

The billing code
The date of service
The quantity
The description and price

And you got that care only once. If your bill shows only totals, you can't spot a duplicate yet. Ask for an itemized bill first with our itemized bill request letter.

Don't use it for 2 separate tests, care on both sides of the body, several doses of a drug, or daily room charges. Those repeats are often correct. A facility fee and a doctor's fee for the same visit aren't duplicates either.

What to fill in

Have your itemized bill and your explanation of benefits (EOB) in front of you. You'll need:

The patient's name, the account number, and the date of service
The details of the doubled charge: its description, billing code, quantity, and price
Where each line appears on the bill, like a line number or page number
If you have insurance, the claim number from your EOB

If your EOB marks the second line with code 18, keep that sentence in the letter. If it doesn't, or you don't have insurance, delete that sentence before you send it.

Fill in your details

Optional. What you type stays on this page. We don't save it or send it anywhere.

Your name

Your address

Your city, state, ZIP

Today's date

Provider name

Provider billing address

Patient name

Account number

Date of service

Description of charge

Billing code

Quantity

Amount of charge

Where the first line appears

Where the second line appears

EOB claim number

Your phone

Your email

Your letter

[YOUR NAME] [YOUR ADDRESS] [YOUR CITY, STATE, ZIP] [TODAY'S DATE] [PROVIDER NAME] Billing Office [PROVIDER BILLING ADDRESS] Re: Duplicate charge Patient: [PATIENT NAME] Account number: [ACCOUNT NUMBER] Date of service: [DATE OF SERVICE] To the billing office: My itemized bill lists the same charge twice. The 2 lines match on the date, billing code, quantity, and price: [DESCRIPTION OF CHARGE], billing code [BILLING CODE], quantity [QUANTITY], $[AMOUNT OF CHARGE] each First line: [WHERE THE FIRST LINE APPEARS] Second line: [WHERE THE SECOND LINE APPEARS] I received this service only once. My explanation of benefits for claim [EOB CLAIM NUMBER] marks the second line with code 18, an exact duplicate. Please: 1. Remove the duplicate charge of $[AMOUNT OF CHARGE]. 2. Send me a corrected itemized bill. 3. Send a corrected claim to my insurer, if needed. 4. Refund any amount I paid for the duplicate charge. If you believe both charges are correct, please check my medical record and explain in writing why both lines apply. Please hold my account while you review this, so it doesn't become past due or go to collections. You can reach me at [YOUR PHONE] or [YOUR EMAIL]. Thank you for your help. Sincerely, [YOUR NAME] Enclosures: copy of itemized bill with both lines marked, copy of explanation of benefits

Highlighted words are blanks you haven't filled in yet.

What to attach

Send copies, never originals.

The itemized bill, with both lines circled
Your EOB for the same visit, if you have insurance
Your receipt or bank statement, if you already paid
Your visit summary or discharge papers, if they show you got the care once

How to send it

Send the letter by certified mail with a return receipt, so you can track delivery. If the provider's patient portal takes messages, you can send it there and attach your copies.

Keep a copy of the letter and everything you attached. Note the date you sent it.

What happens next

The billing office may check your medical record, remove the charge, and send a corrected bill. If you have insurance, check the new EOB after the corrected claim goes through. Your bill should match what the EOB says you owe.

If you don't hear back in about 2 weeks, call and ask about your letter. Write down who you spoke with and what they said.

If the provider says both charges are correct, ask what each one was for. If you still believe the charge is doubled, see how to dispute a medical bill for your next steps.

Common questions

How do I know a charge is a true duplicate?

A true duplicate is the same service billed twice for 1 event. The 2 lines match on the billing code, the date, the quantity, and the price, and you got the care only once. Some repeats are correct, like 2 doses of a drug, care on both knees, or a room charge for each day of a stay. Check your visit summary before you send the letter.

What does code 18 on my EOB mean?

Claim adjustment reason code 18 means your insurer decided a line was an exact duplicate claim or service. It won't pay for it again. The code usually comes with the letters OA, for other adjustment, so the amount isn't listed as your share. If the provider billed you for that line anyway, mention the code in your letter.

Is a facility fee and a doctor's fee for the same visit a duplicate?

No. The hospital or clinic bills for its space, equipment, supplies, and staff. The doctor bills on their own for their work. So 1 visit can show up on 2 bills. Each bill should list its own part only once. Use this letter only when the same bill lists the same charge twice.

What if I already paid the duplicate charge?

Send the letter anyway. It asks the provider to remove the charge and refund what you paid for it. Attach your receipt or bank statement. Ask how the refund will come, like a check or a credit to your card, and when. Keep a copy of your letter and write down who you spoke with.

Sources

Claim adjustment reason codes, X12. Accessed October 1, 2026.
Reading your explanation of benefits (EOB), Centers for Medicare & Medicaid Services. Accessed October 1, 2026.

This is general information, not legal or medical advice. Rules can depend on your plan and your state. Romi Care isn't an insurer, law firm, collection agency, or government program.