Kelli J Burton
1033 Pursglove Court
Springfield city
Arkanzas 4587
5th April 2021
Lenin Hitech Hospital
Billing Department
2482 Star Trek Drive
Pensacola city
Arkanzas 4587
Respected Sir,
This letter is to formally inform you that the bill you gave me for treatment in your hospital on 3rd April, 2021 is inaccurate. I received treatment for a broken arm after an automobile accident on that day. Technicians took x-rays and set my arm, at which time I was discharged. The bill you gave me lists an MRI scan for the cost of $500, which I didn’t have. I have included a copy of the bill with the MRI cost highlighted. I have also included the record of treatment given to me when I was discharged. As you can see, I did not receive an MRI scan.
Based on this information, I request that you send me a new bill that excludes the cost of an MRI scan. I have sent this request within the 20 days limit according to the instructions given to me by you for billing disputes.
I hope to hear from you within two weeks from the date you receive this letter. I can be reached at 555-123-4567.
Thank you for you quick attention to this matter.
Sincerely,
Kelli J Burton