How Pancho works

You get one number. The hospital has dozens of chances to get it wrong.

Studies consistently find that the majority of medical bills contain errors, and the government’s own audit puts billions in improper Medicare payments every year. But checking a bill means knowing coding rules, your insurance contract, and the law in your state. Pancho knows all three.

1

Upload whatever showed up in the mail

A hospital statement, an itemized bill, an Explanation of Benefits, a collection notice, a court summons, a dental or pharmacy bill. Take a photo with your phone or drop in a PDF, JPG, PNG, or WebP — up to five files at a time. If you have an insurance card, add that too; it unlocks a whole category of checks that can’t run without it.

Pancho reads the document, pulls out the provider, the balance, the dates, every line item and CPT code, and figures out what kind of document it is on its own. If you tagged it wrong, it corrects the tag. Bills can be filed under any member of your household.

2

Pancho runs 38 checks while you watch

The scan streams live — you see each check land as it completes, usually inside 15 to 30 seconds. It isn’t one question to an AI. Some checks are code comparing your codes against federal databases, some are date math against legal deadlines, and some are a model reading your line items for coding patterns.

Behind them sit the actual rules: CMS billing standards and NCCI edits, the Medicare Physician Fee Schedule, the No Surprises Act, the Fair Debt Collection Practices Act, IRS §501(r), and the statute of limitations, small-claims limit, credit-reporting ban, and surprise-billing law for your specific state.

3

Read what’s wrong, one issue at a time

You land on a single number: what they’re asking for, and what’s left after the disputes. Then Pancho walks you through the findings one at a time — what the charge is, why it’s wrong, which rule it breaks, and what it’s worth to challenge. Skip any you don’t want to fight.

Every finding is written in plain English, not billing-department language. A duplicate charge is called a duplicate charge. An illegal surprise bill is called legally unenforceable, because that’s what the No Surprises Act makes it.

4

Send the letter that says so

Findings get grouped by who needs to hear about them — the provider, your insurance company, or the collection agency — and Pancho drafts one letter per recipient citing every issue with its statute. There are fourteen letter types, from an itemized bill request to an FDCPA debt validation demand to a charity care application to a cease and desist.

You read the draft, edit it, then either copy the text or send it straight from your Gmail account if you’ve connected one. You send it, not us — every letter is user-reviewed before it leaves. Pancho then tracks the 30-day clock the provider has to respond.

The scan

38 checks, in four groups

Every bill gets the same review a billing advocate would run — except it takes seconds and it doesn’t take a percentage of what you save.

Category A

Coding errors

The mistakes that live inside the codes themselves — the ones you'd need a certified coder to spot.

  • The same procedure billed twice
  • One procedure split into parts to charge more (unbundling)
  • A routine visit billed at a more expensive level (upcoding)
  • Charges for a service you never received
  • Retired or invalid procedure and diagnosis codes
  • Codes that can't legally appear on the same bill
  • The facility and the doctor both billing for the same thing
Category B

Insurance failures

What your plan should have paid and didn't. These checks need your insurance card or benefits summary — without one they're skipped and Pancho tells you so.

  • Balance billing you for what insurance already covered
  • No Surprises Act violations
  • Charges after your deductible or out-of-pocket max was met
  • Copay overcharges and coordination-of-benefits errors
  • Denials that shouldn't have been denied
  • The provider missing its own filing deadline and billing you for it
Category C

Timeline and legal position

Pure date math, no guesswork. Where this bill sits on the calendar decides most of what you can do about it.

  • How long before this can go to collections
  • Whether it can legally hit your credit report in your state
  • Whether the statute of limitations has already expired
  • Your 180-day window to appeal a denial
  • Whether the amount falls under your state's small-claims limit
  • Interest and fees the provider isn't allowed to charge
Category D

Rights and programs

Money you may not owe at all, and rules the other side has to follow.

  • Charity care eligibility, checked against a nonprofit hospital database and your household income
  • IRS §501(r) enforcement when a nonprofit hospital ignores its own financial assistance policy
  • Charges far above the CMS reference price for the same procedure
  • FDCPA violations in a collection letter — missing disclosures, missing validation notice, illegal threats
  • Your right to an itemized bill, and your 30-day right to demand debt validation
  • State surprise-billing protections where your state has them

Each list above is a sample, not the full set. What a given bill actually gets depends on what you uploaded — the insurance checks need an insurance card, and the collector checks need a collection letter.

If it’s already gone further

Collections and court are different problems

A collector has the debt

First question: who are you actually talking to?

Pancho classifies the collector as either an agent collecting on the hospital’s behalf or a buyer that purchased your debt outright, usually for pennies. That single fact changes the entire strategy.

Against a buyer, you negotiate — and Pancho calculates a defensible offer range from how old the debt is and who bought it. Against an agent, you go back to the hospital, because the hospital can still write the bill off entirely. Either way Pancho reads the collection letter for FDCPA violations first, since each one carries up to $1,000 in statutory damages and gives you leverage before you offer a dollar.

57%of people who tried negotiating a medical bill got a reduction, per Consumer Reports. Most people never ask.
You’ve been sued

The deadline is the emergency, not the lawsuit.

Upload the summons. Pancho pulls the court, the plaintiff, the amount, and — the part that matters — the date your answer is due, then escalates its warnings as that date closes in.

It drafts your Answer with the defenses that actually apply, including statute of limitations, lack of standing, and failure to validate the debt. It also drafts fee waivers, continuance motions, remote appearance requests, and motions to vacate if a default judgment was already entered. You print and file them — Pancho is not a law firm and cannot file anything for you.

~70%of medical debt lawsuits end in default judgment, per ProPublica — not because the patient lost, but because nobody showed up.
Straight answers

What Pancho doesn’t do

We don’t mail your letters.

Pancho writes them. You review, then copy the text or send from your own Gmail. Sending on your behalf — including certified mail with return receipt — is something we’re building, not something we do today.

We’re not a law firm.

Pancho is a software tool and billing advocacy advisor. It does not provide legal advice and is not a substitute for an attorney. When a case genuinely needs one, it tells you that instead of pretending otherwise.

The dollar figures are estimates.

What you see is what’s disputable based on the rules a charge breaks — not money already recovered. What you actually get back depends on how the provider responds.

We don’t take a cut.

Traditional medical billing advocates typically charge a percentage of what they save you. Pancho doesn’t touch your recovery — which is the whole reason it works on a $400 bill and not just a $40,000 one.

Find out what your bill actually says.

Pancho is opening to a small group first. Join the waitlist and we’ll reach out personally.

Join the waitlist