Former U.S. Surgeon General Jerome Adams ignited a firestorm on social media last month when he posted a copy of his nearly $5,000 emergency room hospital bill −after insurance paid its portion.

"Recently had an ER visit for dehydration while out of town," he wrote on X, formerly Twitter. "Received some labs and 3 IV bags. Here's the bill- AFTER insurance," Adam noted, showing the hefty tab.

“The situation I was in is one far too many Americans find themselves in,” Adams said in an interview with USA TODAY. “There’s no reason for such inflated costs.”

Adams flagged a major financial stressor for many Americans. Medical bills are the No. 1 reason people file for bankruptcy, accounting for nearly 67% of them a year, according to a 2019 study published in the American Journal of Public Health. An analysis of 2020 Census Bureau data by health policy research firm KFF found U.S. adults owe at least $195 billion in medical debt.

What happened to Dr. Jerome Adams?

Adams said he flew to Arizona in January for a business trip, hiked during the day, went to dinner and felt light-headed. Friends called an ambulance that took him to the nearest emergency room at the Mayo Clinic.

He received IV fluid during the ride, and by the time he arrived at the hospital, felt much better. A test confirmed dehydration.

“Then, I get caught in the system,” Adams said. Over the next 18 hours, he received more IV fluids, lab tests, a chest X-ray to rule out a heart attack and observation time. The next morning, he was released, feeling fine.

"If I had known how much it would cost, I would've said 'No thanks. I'll just go home and drink some Gatorade.'”

“I have a high deductible plan so I knew I’d have to pay for the visit, but I was thinking $1,000 to $2,000 because I could get these services for $500 in my own neighborhood,” he said. “You can have someone come to your house with IV fluid for a couple hundred bucks."

The $5,000 bill left him "flabbergasted."

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What can people do if they get a big medical bill?

Adams said some steps people might consider include:

• Request an itemized bill to see the specific services and charges.

• Research and analyze that information and begin to dispute your bill.

When Adams looked over his detailed bill, for example, he spotted that the hospital categorized his dehydration as a level 5 event, which is more serious and costs more, even though The American College of Emergency Physicians classifies dehydration as a level 4 service.

He also found the hospital charged him 11 times the going rate in the region for his blood test, while his EKG was three times more expensive, and his X-ray twice as costly.

This step takes a lot of time and energy. People often “get tired and frustrated and give up,” he said, and that’s understandable.

• Hire a company to help you.

“You need a lawyer to navigate the legal system so these companies found a gap and a need and may be able to save you” money, Adams said.

Where can I find companies to help me?

• National nonprofit Dollar For, which helps eligible Americans obtain charity care, recommends two for-profit companies, for those who don’t qualify for its services: Goodbill and Resolve. You submit your information and they assign an advocate to work on your case. Neither charges an upfront fee. Instead, they take a percentage of what they save you. If they save you nothing, they get nothing.

Dollar For also provides information on other resources to connect you to people who can help you with insurance and payments.

• If you have a Mastercard and want constant medical bill monitoring, you may be able to link your health insurance accounts to HealthLock, which can protect a user’s medical data from breaches and organize deductibles, claims and provider information in a secure, digital space. Users pay a monthly fee, depending on the services they want.

Whenever you get care, including dental and vision, and new claims are entered, HealthLock can automatically analyze and flag each one for potential errors, fraud or overbilling. You don't have to upload any information. It will look back up to two years to check for irregularities. If it finds them, you can opt to negotiate the problem yourself or use HealthLock, which will take 33% of the dollars it saves you.

“The average family goes to the doctor and has about seven doctor bills a year,” said Scott Speranza, HealthLock’s founder and chief executive. “Our average return is over $350.00 a year per member.”

There’s also no time limit for each case. As long as HealthLock thinks it can recover savings for you, it will work on it, Speranza said. “We just returned $400,000 for (a) client that took us over two years to do so.”

Did Dr. Adams successfully dispute his bill?

Adams continues to fight his bill on his own.

“I would love for the ending to this story to be: ‘Mayo Clinic helps patient to navigate broken system," he said. "The point where I am in this story is where ‘Mayo doubles down on broken system and threatens to send patient to collections if he doesn’t pay.’ We'll see how the story ends...I’m hoping Mayo will be a good actor, but it won’t change the fact that it’s a broken system."

Mayo Clinic responded, saying it's "committed to providing high-quality, high-value care for all its patients, and to ensuring that financial considerations are not an obstacle between patients and the care they need."

Without permission from Adams, it said it couldn't discuss "specific patient circumstances or providing additional clarifying facts."

Medora Lee is a money, markets, and personal finance reporter at USA TODAY. You can reach her at [email protected] and subscribe to our free Daily Money newsletter for personal finance tips and business news every Monday through Friday.