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A Patient’s Rights in Obtaining Medical Bills under Texas Law.

It is important individuals know their rights with regard to hospitals.  A hospital stay can be long, stressful and result in significant medical bills.  Hospitals are obligated to provide the patient with information regarding his/her hospital bills and medical records.

Texas law allows a patient to receive a copy of his/her itemized statement of the services and supplies a hospital provides.  In fact, it requires hospitals to create and implement a written policy regarding billing statements.   The policy must include a periodic review of such statements and a procedure for handling complaints.

Are hospitals required to provide itemized bills?

Only upon request by the patient, a hospital shall provide an “itemized statement of the billed services provided to the person.”  If requested, the hospital must provide the statement on or before the 30th business day after a patient is discharged.

Among other information the itemized statement must be printed in a conspicuous manner, list the date services and supplies were provided and state whether a third party has paid or been billed for the services.

The hospital must provide the patient with information regarding the availability of the billing statement prior to discharge.

A patient may request the itemized billing statement no later than a year after the patient’s discharge from the hospital.  The hospital then has 30 days to provide the billing statement to the patient.

However, a patient is not the only person or entity entitled to receive the itemized statement.  The law also provides that a “third party payor who is actually or potentially responsible for paying” the bill is entitled to receive a copy of the itemized statement.  The law provides that a third party payor must request the statement from the hospital and must have received a claim for payment.  Among others, a third party payor can be a health insurance carrier, a workers compensation carrier, Medicare, Medicaid or Tricare.  The request for the billing statement must be made within a year from receipt of the claim for payment and the hospital has 30 days to comply.

If more than 2 copies are requested the hospital may charge a reasonable fee for the additional copies.

About the Author

With over 100 years of combined experience among the legal team of Herrman & Herrman, P.L.L.C., our Texas personal attorneys have successfully resolved over 20,000 cases. When representing injured Texas residents, we fight for justice against wrongdoing and aggressively pursue the best resolution to complex personal injury claims. Start down the road to recovery by contacting us for a free initial consultation and case evaluation.