How BillHero works

A clear look at what happens when you upload a bill.

We don't want you to be surprised by what BillHero does — or by what it doesn't. This page walks through the full flow, what the AI agents actually do, what happens to your data, and where you still have to use your own judgment.

The flow

You upload your documents

Drag and drop your Explanation of Benefits (EOB), your itemized hospital or doctor bill, or a photo of either. PDFs and images both work. You also pick which insurance plan the claim was billed under (BillHero needs this to cite your actual policy language in the appeal).

Files are sent over TLS 1.3, processed in server memory, and deleted immediately after your report is generated. We never store the text of your uploaded documents.

Specialized AI agents analyze the claim

A small team of focused AI agents runs in sequence, each doing one thing well:

Parser — reads your EOB and extracts structured fields: CPT codes, billed amounts, denial reasons, provider info, deductible status.
Researcher — looks up what each CPT code should mean, common upcoding patterns, and whether the denial reason is one insurers are frequently overturned on.
Analyst — scores each issue on appeal strength, estimates the dollar amount recoverable, and flags deadlines.
Letter writer — drafts a professional appeal letter citing your specific Summary of Benefits language plus relevant federal statutes.
Citation reviewer— checks every legal citation in the draft letter against an allowlist of verified federal statutes. If the letter cites a law we can't confirm, the letter ships with a warning banner telling you to verify or remove that citation before mailing.

You get a report you can act on

Your report has five tabs: an overview with next steps, a ranked list of issues with win probabilities, the full appeal letter (copy or download), a submission checklist plus follow-up phone script, and a timeline to log notes as your appeal moves through review.

You decide what to send. You write in corrections. You call the insurer. BillHero does the analytical heavy lifting and drafts the paperwork — the judgment and the signature are yours.

What BillHero does — and what it doesn't.

Before you sign up, we want you to see both sides laid out next to each other.

✓ What BillHero does

→Reads EOBs, itemized bills, and insurance summaries, and extracts structured data.
→Detects common billing errors: duplicate charges, upcoding, preventive-care-coded-as-diagnostic, out-of-network surprise bills, medical-necessity denials.
→Scores each issue on appeal strength and estimates the recoverable dollar amount.
→Drafts a professional appeal letter that cites your specific policy language by name and references relevant federal statutes.
→Gives you a submission checklist and a phone script for the inevitable follow-up call.
→Lets you log timeline notes so when you call the insurer three weeks later, you have your reference numbers handy.

✕What BillHero doesn't do

→Give legal advice. BillHero is an educational and assistive tool. For complex disputes, consult a licensed healthcare attorney or patient advocate.
→Give medical or clinical advice.We don't tell you whether a procedure was appropriate or suggest alternative treatments. That's your doctor's job.
→Guarantee you'll win. Appeal success depends on your specific facts, plan terms, and reviewer. Published overturn rates for first-level internal appeals land in the 40–80% range, but your case is your case.
→Submit the appeal for you. You review, sign, and mail or fax the letter. This is intentional — the signature is yours, and so is the final word on what gets said.
→Talk to your insurer on your behalf. No calls, no portal submissions, no negotiating. The phone script is for you to use.
→Catch everything.AI makes mistakes. Every letter gets a citation-review warning when a legal reference can't be verified, and every report comes with a reminder to sanity-check before you mail.

Under the hood

For the readers who want to know what's actually happening.

Citations are allowlisted, not generated freely

AI models are famous for inventing plausible-sounding laws. We constrain the letter writer to cite from a vetted list of federal statutes (ACA §2713 for preventive care, ERISA §503 for appeal rights, the No Surprises Act, etc.). Any citation that falls outside the list triggers a review warning on your report — so you never mail a letter that cites a law that doesn't exist.

PHI never leaves our process

Your uploaded document text is never sent to an analytics service, error tracker, or logging system. We strip dollar amounts, claim numbers, CPT codes, and dates out of every log line before it leaves the server. If we hit a bug, our engineers see a stack trace — they don't see your claim.

Reports are encrypted at rest

Your report lives in our database encrypted with AES-256-GCM. BillHero staff cannot read your reports. If we ever needed to investigate a technical issue with your account, we'd need you to grant access explicitly.

Things you still have to do yourself

This isn't the exciting part of the pitch, but it's the honest part. After BillHero hands you a report, you still:

1.Read the letter carefully. The AI gets facts right most of the time; occasionally it gets a date or a dollar amount wrong. Five minutes of proofreading saves your appeal.
2.Confirm any citation flagged by the citation reviewer — or delete it. Don't mail a letter that cites a law you haven't verified.
3.Gather the supporting documents the report asks for (medical records, referral letters, plan documents).
4.Send it. Certified mail with return receipt, or via your insurer's portal. Keep a copy.
5.Follow up. Use the phone script. Log each call in your timeline so you have a paper trail if it escalates.

Ready to see your bill?

Your first analysis is free, no card required. It takes about three minutes.

BillHero is an educational and assistive tool only. Not legal, medical, or insurance advice. Results are not guaranteed.