AI medical bill tools in 2026: pricing, fees, and free options
The 2026 problem: denials are common; appeals are rare
A large bill or denial is not unusual—and neither is leaving it unchallenged. In 2024, insurers offering HealthCare.gov plans denied 19% of in-network claims and 37% of out-of-network claims, for a combined average of 20%. In-network denial rates ranged from 3% to 36%. Fewer than 1% of denied claims were appealed; among appeals, 66% were upheld. These figures cover ACA Marketplace plans, not every type of insurance. (KFF)
The financial stakes are substantial. People in the United States owe at least $220 billion in medical debt; approximately 14 million adults owe over $1,000 and about 3 million owe more than $10,000 (KFF medical-debt report). A KFF survey found that 41% of adults currently have some debt caused by medical or dental bills, and 24% say they currently have medical or dental bills that are past due or that they are unable to pay (KFF health-care debt survey).
Credit consequences matter, too. A federal judge blocked a recently finalized Consumer Financial Protection Bureau rule that would have removed medical bills from credit reports. Among adults with health-care debt, more than a third said it had negatively affected their credit score; that rose to 46% of Black adults and 40% of adults who incurred the debt while uninsured. (KFF)
These numbers make help worth considering, but they do not prove a paid service will succeed on any particular bill. The practical question is what the service charges, what remains after its fee, and whether a free route fits the problem.
Proof the system folds when pushed, for free
A paid negotiator is not the only way to start. KFF Health News reported that five of 12 patients profiled in its 2025 “Bill of the Month” series had their bills mostly or fully forgiven soon after the newsroom contacted the provider and insurer for comment. That is a small set of cases, not a success-rate estimate—but it is a reminder that asking the billing parties to review a bill can matter before paying someone else to negotiate. (KFF Health News)
For a hospital bill, Dollar For says it helps patients apply for hospital financial assistance programs for free. It says nonprofit hospitals must offer programs that forgive bills and that many for-profit hospitals also offer help. Eligibility and available assistance depend on the hospital and circumstances; the first step can be to ask the hospital about its financial assistance policy.
There may also be a specific federal protection to check. The No Surprises Act took effect January 1, 2022, and protects against certain unexpected out-of-network bills for emergency care, non-emergency care at in-network hospitals, outpatient departments and ambulatory surgical centers, and air ambulances. Uninsured and self-pay patients can get good faith estimates and may be able to dispute a bill if it is at least $400 more than the estimate. (CMS)
Three fee models: contingency, flat, and free
Contingency: pay a share of savings
Goodbill says, “the cost to the patient is 20% of the savings made.” It also says, “The patient keeps 80% of the savings that Goodbill finds. The Goodbill fee is capped at $1000.” The fee applies only if a settlement is negotiated. Its stated method is a “certified medical coding audit” plus software to identify inflated charges, a negotiation letter, and follow-up. (Goodbill fee terms)
Scope is narrow: Goodbill says it only helps with hospital bills “for now,” that it supports only bills “that haven’t been paid yet,” and that it does not handle bills already in collections. Its patient page says, “Lower your hospital bill by up to 100%, even if you have insurance” and “It’s 100% free unless we find you savings.” Those are company claims, not a guarantee. Goodbill publishes no success rate. (Goodbill FAQ; Goodbill patient page)
Resolve charges by bill size. For bills from $5,000 to $15,000, its published terms are: “$249 upfront deposit… applied to your final success fee (or refunded if we don’t lower your bill). The final success fee is 25% of total savings found. If we find more than $0 but less than $4k in total savings, the success fee is instead the lower of $1,000 or 50% of savings found. We never charge you more than you save.” For bills over $15,000: “$499 upfront deposit… Our final success fee is 10% of total savings found. If we find more than $0 but less than $25,000 in total savings, the success fee is instead the lower of $2,500 or 50% of savings found. We never charge you more than you save.” Resolve says it accepts bills in collections. (Resolve fee terms)
The “lower of” clauses are ambiguous. They say the fee “is instead” the lower of a dollar figure or 50% of savings, which reads as an override of the regular percentage—not simply a cap—and the published text does not resolve the question. Get the exact fee calculation in writing before signing.
CareRoute’s own terms are “25% of savings (or 18% for CareRoute app premium subscribers), capped at $1,000. There is no upfront cost.” It also publishes a market range: “Most medical bill negotiation services charge a contingency fee of 10% to 35% of the money they save you, with no upfront cost.” That is the company’s characterization of the market, not an independent survey. (CareRoute)
Flat: pay a fixed amount, not a percentage
mediloop lists “Pay Per Bill … $129 one-time … Full refund if we don’t lower your bill by at least $129” and “Annual Plan … $42/mo · $499 billed once a year … Up to 6 bills reviewed and negotiated … Full $499 back if your bills aren’t lowered by at least $499 combined.” Its stated answer to whether it takes a percentage is: “No. Our pricing is flat, you pay the same fee whether we save you $500 or $50,000. No commission, no percentage cut.” Bills already in collections go through a separate “contact first” process; the company says it offers a sliding-scale fee for financial hardship. (mediloop pricing)
A flat fee is easier to budget, but it still costs money when savings barely exceed the fee. Check which plan applies and whether the refund condition matches the situation.
Free: appeals, estimates, and financial assistance
Counterforce Health says it is “completely free for individuals” and that it will never accept money from insurance companies. It says its funding comes through grants from the NIH and University of Pennsylvania, and offers AI appeal drafting, “Maxwell Voice AI” (beta), and free 1:1 case management. (Counterforce Health)
All performance figures on its page are self-reported vendor claims, not independently verified here: “10K+ Appeals,” “2 Minutes Avg. time to appeal,” “2x Win rate vs. national avg.,” “850M claims denied annually,” “<1% of denials are ever appealed,” and “75% of appeals get approved.”
Granted says creating an account, connecting insurance, and opening cases are free, and that a fee is collected only on savings with consent. Its fee is “10% Fee Per amount saved,” and its own page states “Granted takes a 10% fee on the amount we save you capped at $300.” Its reported “42 Hours saved, $785 Dollars saved” is footnoted: “Average reduction among closed cases with a recorded reduction, Nov. 2024–Aug. 2026. Results vary; not guaranteed.” Its “50,000 Families,” “6MM+ Bills analyzed,” and “1,300+ insurances and patient portals” figures are also self-reported, as are the lines it reproduces: “8 of 10 medical bills contain errors — MBAA” and “93% of patients never dispute the charge — Mercer, 2026 Survey on Health & Benefit Strategies.” None is independently verified here. (Granted)
For a denied insurance claim, Counterforce’s appeal-drafting approach is different from bill negotiation: it aims to help contest an insurer’s coverage decision. For a price estimate, the free nonprofit FAIR Health Consumer uses tens of billions of commercial claims and tens of billions of Medicare claim records for 10,000 services, dating back to 2002; it says its estimates are updated twice each year.
Claimable is another reported appeal-letter tool, not an established 2026 price comparison. NBC News reported on July 18, 2025, that it generated customized appeal letters with clinical-research assessments and other patients’ appeal history, with “The cost: around $40.” Pricing for 2026 is not established by the available source; do not treat that reported figure as current. (NBC News)
Side-by-side comparison
“Not stated” means the cited source does not provide that detail; it is not an assumption about the service.
| Service | Type | Fee model | Published terms | Cap | Upfront cost | No-savings / refund terms | Collections | Scope limits | Source |
|---|---|---|---|---|---|---|---|---|---|
| Goodbill | Hospital bill negotiation | Contingency | “the cost to the patient is 20% of the savings made”; fee only if a settlement is negotiated | “The Goodbill fee is capped at $1000” | Free unless savings are found | “It’s 100% free unless we find you savings” | Not accepted | Hospital bills only “for now”; only unpaid bills; not bills in collections | Fee terms; FAQ; patient page |
| Resolve | Bill negotiation | Contingency with deposit | $5k–$15k: “$249 upfront deposit” applied to final fee; 25% success fee, with stated “lower of $1,000 or 50%” clause below $4k savings. Over $15k: “$499 upfront deposit”; 10% success fee, with stated “lower of $2,500 or 50%” clause below $25,000 savings. “We never charge you more than you save.” | No published fee cap beyond “never charge you more than you save” | $249 or $499, by bill tier | Deposit refunded if the bill is not lowered | Accepted | not stated | Resolve |
| Granted | Bill and insurance support | Savings-based | “10% Fee Per amount saved”; page states “Granted takes a 10% fee on the amount we save you capped at $300”; account, insurance connection, and case opening are free; fee collected only on savings with consent | $300 | Free to create account and open cases | not stated | not stated | not stated | Granted |
| mediloop | Bill review and negotiation | Flat | “Pay Per Bill … $129 one-time”; “Annual Plan … $42/mo · $499 billed once a year … Up to 6 bills reviewed and negotiated” | not stated | $129 one-time or $499 billed once a year | Full refund under the published savings thresholds | Separate “contact first” process | not stated | mediloop |
| CareRoute | Bill negotiation | Contingency | “25% of savings (or 18% for CareRoute app premium subscribers)” | $1,000 | No upfront cost | not stated | not stated | not stated | CareRoute |
| Dollar For | Financial assistance application help | Free nonprofit help | “It’s quick, easy, and free” | not stated | Free | not stated | not stated | not stated | Dollar For |
| Counterforce Health | Insurance appeal support | Free for individuals | “completely free for individuals”; AI appeal drafting and free 1:1 case management | not stated | Free | not stated | not stated | not stated | Counterforce Health |
| Claimable | AI appeal letters | Reported one-time price | NBC reported “around $40” on July 18, 2025; 2026 pricing not established | not stated | not stated | not stated | not stated | not stated | NBC News |
The arithmetic: what you actually keep
The examples below are our arithmetic, not vendor claims. They assume the cited fee applies and compare savings before any other costs. Resolve examples show the regular percentage calculation before the special “lower of” clause; confirm the final charge in writing.
- $1,000 saved: Goodbill’s 20% fee is $200, leaving $800. A $129 mediloop one-time fee leaves $871. A $499 mediloop annual plan leaves $501.
- $4,000 saved: Goodbill’s 20% fee is $800, leaving $3,200. Resolve’s $5k–$15k tier at 25% leaves $3,000 before considering its special clause. A $129 flat fee leaves $3,871.
- $8,000 saved: Goodbill’s 20% would be $1,600, but its $1,000 cap applies, leaving $7,000. Resolve at 25% leaves $6,000. A $129 flat fee leaves $7,871.
- $20,000 saved: Goodbill’s capped fee leaves $19,000. Resolve’s over-$15,000 tier at 10% leaves $18,000 before its special clause. A $129 flat fee leaves $19,871.
Goodbill’s cap binds at $5,000 in savings: 20% of $5,000 is $1,000, so additional savings do not increase its fee beyond that published cap. The Resolve figures are less straightforward because the published “is instead the lower of” clauses may change the regular percentage fee. Do not rely on the examples as a final quote from Resolve.
When paying is a mistake
A paid service is not automatically worthwhile because a bill is large. It may be a poor fit when a free financial-assistance application, a direct billing-office review, or an applicable federal protection could address the issue first.
Check scope before sharing documents or paying a deposit. Goodbill’s stated limits mean it is not an option for bills already paid, bills already in collections, or non-hospital bills. Resolve says collections are accepted; mediloop says to contact it first for bills already in collections. For the other services in the table, collections coverage is not stated in the cited material.
There is also no reason to pay a bill negotiator to write an insurance appeal if the need is specifically to challenge a coverage denial and a free appeal resource fits. Conversely, an appeal-writing tool is not the same thing as a service negotiating a hospital facility charge. Match the service to the problem, then compare its fee with the potential savings.
The free-first ladder
- Identify the problem. Separate a provider bill from an insurer’s denial or an estimate dispute. They may call for different routes.
- Ask for a review directly. Request an itemized bill and ask the provider’s billing office to explain the amount and available financial assistance. KFF Health News’ 2025 cases show that some bills were mostly or fully forgiven after the provider and insurer were contacted, but do not establish a typical result. (KFF Health News)
- Check assistance and protections. Try Dollar For for hospital financial assistance. If an uninsured or self-pay bill is at least $400 above a good faith estimate, review the CMS dispute path.
- For a denial, start with the free route. Consider Counterforce Health for appeal support; check the insurer’s denial notice for its stated appeal process and deadlines.
- Compare a paid offer only after that. Get the fee, scope, refund terms, and any special calculation in writing. Estimate the net amount left after the fee, not just the advertised reduction.
AI appeal tools vs. negotiation services: different jobs
AI appeal tools help prepare a case challenging an insurer’s decision. Bill negotiation services seek a reduction in a provider’s charge or balance. A denied claim may need an appeal; a hospital facility bill may need billing review or negotiation; some situations could involve both, but one service’s advertised savings do not establish that it handles the other job.
The word “AI” does not say what work is included, whether a human reviews the output, or what a fee covers. Confirm those in the service’s published terms before paying. This article is cost math, not medical or legal advice.
FAQ
Is a free tool always the better choice?
Not necessarily. Free help avoids a service fee, but it may not provide the same service or scope as a paid negotiator. Start by identifying the task and compare any paid fee with the amount that might remain after it.
Does Goodbill handle a physician’s bill or a bill in collections?
No. Goodbill says it helps with hospital bills “for now,” supports only bills “that haven’t been paid yet,” and does not handle bills already in collections. (Goodbill FAQ)
What does Resolve charge if savings fall under its special thresholds?
Its published language says the fee “is instead the lower of” a dollar amount or 50% of savings, but does not clarify how that interacts with its regular percentage fee. Get the calculation in writing before signing. (Resolve)
Is Claimable’s reported $40 price current for 2026?
The available report is from July 18, 2025, and says “around $40.” A 2026 price is not established by that source. (NBC News)
When can an uninsured or self-pay patient dispute a bill against an estimate?
CMS says such patients may be able to dispute the bill if it is at least $400 more than the good faith estimate. Check the federal CMS medical bill rights information for the applicable process.
The Bottom Line
The fee model can change what remains: Goodbill takes a percentage but caps its fee at $1,000; mediloop publishes flat fees; Resolve uses bill-size tiers and has an unclear special-fee clause; CareRoute publishes a capped percentage; and Granted says its fee is based on savings with consent. Free options include hospital financial assistance help, appeal support, and price estimates.
Start with free routes and protections that match the problem. If considering paid help, verify scope and refund terms, get ambiguous pricing in writing, and compare the net savings—not the headline reduction. HealthyWallet has not tested these services.
How This Guide Was Built
This is a documentation-based comparison. We did not test, sign up for, or submit a bill to any service. Pricing reflects vendor-published pages read in the current window; Claimable’s price is reported by NBC News in July 2025 and is not established as current for 2026. Vendor statistics are identified as self-reported where applicable and are not independently verified here. The KFF figures are independent. This article is cost math, not medical or legal advice.