Frequently Asked Questions

NilesAI is a medical bill analysis platform that scans your bills against 16 deterministic validation engines and over 2.6 million billing rules to identify overcharges and errors. We provide cited findings, dollar impact estimates, and ready-to-send dispute letters. Learn more on our homepage.

You upload your medical bill (EOB, itemized bill, or hospital statement). NilesAI extracts every line item, then runs all 16 scan engines against each charge. These engines check for issues like duplicate charges, upcoding, NCCI bundling violations, fee schedule variances, and more. Results are ready in under 3 minutes. See how our 16 scan engines work.

NilesAI is a technology platform, not a billing advocate or legal service. We identify potential errors and provide tools to dispute them, but we don't negotiate on your behalf or provide legal advice. Our findings are informational and meant to help you make informed decisions.

NilesAI uses deterministic, rules-based analysis — not guesswork. Every finding is generated by checking specific billing rules (CMS NCCI edits, MPFS rates, MUE limits, modifier rules). This means our findings are verifiable and cited. However, some findings may require clinical context that only your provider can confirm.

NilesAI accepts Explanations of Benefits (EOBs), itemized bills, hospital statements, and CMS-1500/UB-04 claim forms. We support PDF, image (JPG, PNG), and scanned documents. For best results, upload both the EOB and the itemized bill so we can cross-reference charges.

Most bills are analyzed in under 3 minutes. Complex bills with many line items may take slightly longer. You'll receive a notification when your analysis is complete.

Yes. We use AES-256 encryption at rest and TLS 1.3 for data in transit. All documents are stored in SOC 2-compliant infrastructure. Read our full privacy policy.

Yes. NilesAI is built to meet HIPAA requirements. We offer Business Associate Agreements (BAAs) for enterprise and professional customers. PHI is handled according to HIPAA privacy and security rules.

No. We never sell, share, or monetize your personal health information. Your documents and analysis results are only accessible to you. We use third-party service providers for infrastructure, all of whom are bound by data protection agreements.

No. NilesAI uses deterministic, rules-based scan engines — not AI language models — for bill analysis. Your PHI is never sent to any AI model for processing. Our analysis is based on published CMS rules, fee schedules, and coding databases.

Yes. You can request deletion of your account and all associated documents at any time. We honor deletion requests within 30 days. Contact us to submit a deletion request.

NilesAI offers a free tier with 3 scans per month (summary reports). Detailed reports with full findings, dispute letters, and fair price data are $29 per case. Enterprise and volume pricing is available. See our pricing.

The free plan includes 3 bill scans per month with summary-level findings. You'll see the number of issues found and their severity. Detailed findings with CMS citations, dollar impact, fair price comparisons, and dispute letter generation require a paid report.

Yes. NilesAI uses per-case pricing, not subscriptions. You only pay when you request a detailed report. There are no recurring charges to cancel unless you're on an enterprise plan.

If NilesAI fails to produce a report due to a technical issue on our end, we'll refund the charge. Since reports are delivered instantly, we generally don't offer refunds for completed analyses. Contact us if you believe there's an issue with your report.

We accept all major credit and debit cards (Visa, Mastercard, American Express, Discover) through our secure payment processor. Enterprise customers can arrange invoicing.

We occasionally offer promotional pricing and voucher codes. Enterprise and high-volume customers receive custom pricing. Contact us for details.

A finding is a specific issue NilesAI identifies on your bill. Each finding includes the charge in question, the rule that may be violated (with CMS citation), the severity level, and the estimated dollar impact. Findings range from definitive errors (like invalid CPT codes) to potential concerns that warrant review.

After reviewing your findings, you can confirm findings you want to dispute (which adds them to your dispute letter) or dismiss findings you've reviewed and determined are correct. This helps you focus on the issues that matter most.

Yes. We recommend uploading both your EOB and itemized bill to the same case. NilesAI's cross-document analysis compares charges between documents to catch mismatches that single-document review would miss.

NilesAI uses three severity levels: High (definitive billing rule violation with clear dollar impact), Medium (potential issue that warrants review or clinical context), and Low (informational finding or minor discrepancy).

Yes. You can export your findings report as a PDF for your records, share it with an attorney, or use it as documentation when disputing charges with your provider or insurer.

Yes. NilesAI generates a ready-to-send dispute letter that cites the specific findings, CMS rules, and dollar impact. You can customize the letter before sending it to your provider's billing department. Learn more about negotiating your bill.

Studies consistently show that up to 75% of medical bills contain errors. These range from simple data entry mistakes to systematic upcoding and unbundling. Read our comprehensive report on medical billing errors.

First, request an itemized bill if you don't have one. Document the specific errors with codes and amounts. Then contact your provider's billing department. If they don't resolve it, file a complaint with your insurer or state insurance commissioner. See our step-by-step review guide.

An EOB is a document from your insurance company that details how a claim was processed. It shows what was billed, what insurance covered, and what you owe. It's not a bill, but comparing it to your provider's bill is critical for catching errors. Learn how to read your EOB.

The No Surprises Act (effective January 2022) protects patients from surprise out-of-network bills in emergency settings and at in-network facilities. It bans balance billing in these situations. Read our complete guide to the No Surprises Act.

Yes — and you should. Studies show 93% of people who try to negotiate succeed. Strategies include disputing errors, requesting cash/self-pay rates, negotiating using Medicare rates as an anchor, and applying for financial assistance. See our negotiation guide with scripts.

Non-profit hospitals (501(c)(3)) are legally required to offer financial assistance programs, also called charity care. If your income is below a certain threshold (often 200-400% of the Federal Poverty Level), you may qualify for discounted or free care — even after treatment. Only 10-15% of eligible patients apply. Learn how to apply.