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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.