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.
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.