Dear Sir or Madam : I am writing to dispute the following information in my file. I pasted the dispute below. 
I am requesting that the item be removed or explained with evidence of an actual debt owed to correct the information. This debt of {$100.00} is not unknown to me but also seems unlikely as I have insurance for many years. Please provide the date of service and any information you may have as this debt seems erroneous. 
Please reinvestigate this matter and delete or provide evidence that the disputed item is valid as soon as possible.