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.

Marshall spent a decade reporting on health care for ProPublica, and his work there was a huge inspiration for this show. Partly because, in addition to being tough and tenacious, Marshall was also funny. 

Check out I’m a Journalist. Apparently, I’m Also One of America’s “Top Doctors,” in which he exposes a rotten scam — “top doctor” and “super doctor” awards that are nothing but money-making schemes with no connection to physicians’ achievements — by playing along with it (and getting ProPublica to let him expense the adventure). 

He talked with us in 2019 about medical devices that spy on their users, and in 2021 about his book.

Before journalism, Marshall was a full-time minister for years, and his essay From Ministry to Muckraking: The Biblical Basis for Investigative Reporting is terrific.

He never stopped looking for ways to be of service. In the last year, he built a chatbot to help people get advice from a virtual version of himself. You can consult it on his website right now. This episode is an extended version of a recent installment of the NPR and KFF Health News series Bill of the Month.

That’s all for now. Here’s a transcript of this episode. 

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