Caitlyn Mai expected her share of a recent surgery bill to be about $2,000, with insurance covering the rest. 

Then she started getting alerts on her phone from the hospital that she owed $139,000 — the full cost of her surgery. 

But Caitlyn, a legal assistant in Oklahoma, instinctively knew a cardinal rule of the American healthcare system — “never pay the first bill.” 

It’s a lesson we first heard from the journalist Marshall Allen, whose 2021 book Never Pay the First Bill serves as a how-to guide for anyone facing down a potentially bogus medical bill, and whose passing earlier this year left a giant hole in the hearts of many. 

This episode is an extended version of a recent installment of the NPR and KFF Health News series Bill of the Month. 

Here’s a transcript of this episode. 

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