Hospital Overcharging Complaint

To, The Medical Superintendent / Grievance Officer [hospital_name] [hospital_address] Date: [complaint_date] Subject: Complaint regarding excessive and unexplained billing — [patient_name], IP no. [admission_number] Sir/Madam, 1. PARTICULARS Patient : [patient_name] Complainant : [complainant_name] IP / admission : [admission_number] Admitted : [admission_date] Discharged : [discharge_date] Total billed : Rs. [total_billed] Insurance : [insurance_status] 2. THE CHARGES DISPUTED [disputed_items] 3. I request that you kindly furnish: (a) a FULLY ITEMISED BILL setting out each charge separately, with dates, quantities and unit rates; (b) the case sheet, treatment records, investigation reports and medicine administration record; (c) the hospital's published schedule of rates for the services charged; and (d) a written explanation for each item identified above. 4. That charging for services not rendered, duplicating charges, billing consumables not used, or levying rates in excess of those published or agreed constitutes a DEFICIENCY IN SERVICE and an UNFAIR TRADE PRACTICE under the Consumer Protection Act, 2019. 5. I request a revised bill and refund of the excess within FIFTEEN DAYS, failing which I shall approach the appropriate Consumer Commission and the State regulatory authority, at your risk as to costs. Yours faithfully, [complainant_name] Contact: [contact_number] ENCLOSURES 1. Copy of the bill and all payment receipts 2. Discharge summary 3. Insurance correspondence, where applicable ──────────────────────────────────────────────────────────────── ASK FOR THE ITEMISED BILL FIRST — EVERYTHING FOLLOWS FROM IT A consolidated bill saying "pharmacy" or "consumables" against a large figure cannot be checked, and cannot be disputed with any precision. An itemised bill can, and hospitals are generally required to provide one. Ask for it in writing before you argue about anything. WHAT TO LOOK FOR when you have it: - Charges for days after discharge, or before admission - The same investigation billed twice - Consumables in quantities that do not match the treatment - Room rent at a higher category than the room actually occupied, which often drags other charges up with it since many tariffs are linked to room category - Doctor visit charges on days no visit is recorded in the case sheet - Charges for equipment that was standing in the room unused YOU ARE ENTITLED TO YOUR MEDICAL RECORDS. Ask for the case sheet and treatment records; they are what allow the bill to be checked against the treatment actually given. A HOSPITAL CANNOT DETAIN A PATIENT OR A BODY OVER AN UNPAID BILL. This happens, and it is unlawful. If it is happening, telephone the police and the hospital's own grievance officer immediately, and raise it with the State authority afterwards — a bill dispute is a civil matter and does not justify confinement. IF INSURANCE IS INVOLVED, get the insurer's deduction sheet. Insurers routinely disallow items as non-payable or as inflated, and that document is independent evidence about the very charges you are disputing. WHERE TO ESCALATE: the hospital's grievance officer, then the State authority under the Clinical Establishments Act or the equivalent State legislation, then the District Consumer Commission. Where the complaint is about the TREATMENT rather than the bill, the State Medical Council is the forum for professional misconduct.