← back to the guide

Part 02 · The Playbook

One step at a time.

A big bill feels like an emergency, but you usually have months to work it. Here is the order that tends to work best. Start at the top and go as far down as you need to.

do this before you pay anything

Five steps for a scary bill

Do not pay a large hospital bill the day it arrives. A few steps first can lower it, and some of them only work if you act before the bill goes to collections.

Ask for an itemized bill

The first bill you get is usually a summary. Ask for the full itemized version with billing codes, then read it for duplicate charges, services you never got, or a room rate for days you had already left. In North Carolina, a hospital has to give you an itemized bill on request, written so an ordinary person can understand it. NC Gen. Stat. 131E-91

Apply for financial assistance

Every nonprofit hospital is required to have a financial assistance policy, sometimes called charity care, and to tell you about it. Depending on your income, it can cut the bill partway or wipe it out entirely. Apply even if you think you earn too much, since the income limits are often higher than people expect.

Timing matters here. At a nonprofit hospital you generally have at least 240 days from your first bill to apply, and they cannot send you to collections in the first 120 days. IRS, 501(r) financial assistance If filling out the form feels like a lot, Dollar For is a nonprofit that helps you do it for free.

If you're uninsured, ask for the discount

Without insurance, you start out billed at the full list price. Most large hospitals have a self-pay or uninsured discount that brings it down a lot, and they do not always offer it unless you ask. Some apply it automatically. Combine it with financial assistance if you qualify for both.

If it's a cash price, negotiate it

If you're uninsured or paying a self-pay balance, the price itself is negotiable. Ask for the rate Medicare or a typical insurer would pay for the same care, offer that, and keep it in writing so you have a record of what was agreed.

If you're insured, this step works differently. Your deductible and coinsurance are set by your plan, so there is usually no price to haggle. Your better moves are making sure the claim was billed and coded correctly and appealing it with your insurer if it was not. A wrong code can cost you more than any discount would save.

Set up a payment plan you can keep

Once the number is settled, ask for an interest-free monthly plan sized to what you can actually afford. Get the final balance and the monthly amount in writing before you pay. Try not to put a hospital bill on a credit card, since that trades a flexible, interest-free debt for an expensive one.

A North Carolina shortcut

If your bill is from one of the roughly 99 NC hospitals in the state debt-relief program, some older debt may be forgiven automatically, with nothing for you to do. You cannot apply for it, so be wary of anyone who asks you to. There is more on how that works on the next page. NCDHHS medical debt

Where to start in District 31

Financial assistance, by hospital

These are the systems most people in Stokes and Forsyth counties are billed by. Each link goes to the hospital's own financial assistance page. Always confirm current details with the hospital directly.

Novant Health · Forsyth Medical Center Uninsured patients up to 300% of the federal poverty level can qualify for a full write-off. Financial counselor (336) 718-5393, billing (888) 844-0080. Atrium Health Wake Forest Baptist Full assistance at or below 300% of the poverty guideline, and an automatic 50% discount for uninsured patients. (336) 716-3988 or (877) 938-7497. Cone Health Full assistance at or below 200% of the poverty guideline, with partial help on a sliding scale above that. (336) 832-7000. Community Hospital of Stokes · Danbury Now part of Novant Health as of June 2026, so Novant's financial assistance applies. If you were billed under the previous operator, call the Novant financial counselor line above to check.

People who help for free

Dollar For Helps you find and file hospital charity care applications. Their tool covers thousands of hospital policies. Legal Aid of North Carolina Free legal help for those who qualify. Helpline (866) 219-5262, weekdays. Patient Advocate Foundation Case management for people facing a serious or chronic diagnosis. (800) 532-5274. NC Attorney General · Consumer complaint File a complaint about a billing or collections problem. (877) 566-7226.

This page is general information, not legal or financial advice. Rules and hospital policies change, so verify the details that apply to you using the links above. Verified as of June 2026.

The rights you already have