Short Answer

In North Carolina, start by requesting a free itemized hospital bill for the emergency-room date of service and asking whether the hospital’s statement includes only the facility charges. Then ask for the names and billing contacts for any separately billing groups (emergency physician, radiology, lab, etc.) and request their itemized professional bills (or written confirmation that no separate professional claims were billed). Even if your health coverage shows “paid” and the hospital account is at a zero balance, separate professional bills can exist and may be processed under different billing systems.

Understanding the Problem

If you had an emergency-room visit in North Carolina and the hospital says the account is paid with a zero balance, you may still wonder: can there be a separate emergency physician or radiology bill that is missing from the paperwork your lawyer is reviewing, especially when you are trying to confirm whether the hospital bill includes everything for that date of service?

Apply the Law

North Carolina law gives patients the right to request an itemized list of hospital charges after discharge, and it also recognizes that medical billing and records are kept by different entities (a hospital facility versus independent physician groups). Practically, that means you often need to request two categories of documentation: (1) the hospital’s facility billing detail and (2) any separately billed professional charges (like emergency physician services or radiology interpretation). If a personal injury claim is involved, providers may also need to supply itemized statements and related records to support lien rights tied to any recovery.

Key Requirements

• Get the hospital’s itemized charges: Ask the hospital billing office for an itemized list for the date of service so you can see what the hospital billed as the facility (often including ER room/facility fees, supplies, medications, and sometimes imaging technical charges).
• Confirm whether professional fees are separate: Ask whether the emergency physician, radiologist, pathologist, or other clinicians bill separately from the hospital (many do).
• Identify the separate billers: Request the legal name and billing contact information for each professional group involved so you can request their statements directly.
• Request itemized professional statements: Ask each separate biller for an itemized statement for that date of service (and, if needed, a “zero balance” letter showing insurance processed the claim).
• Request records if needed to match services to bills: If the billing detail does not clearly match what happened in the ER, request the relevant medical records (for example, the radiology report) so you can confirm whether a professional interpretation occurred.
• Track lien-related documentation (injury claims): If the bills relate to a personal injury claim, request the itemized statement and any written lien notice so you can confirm what is being asserted against any settlement funds.

What the Statutes Say

• N.C. Gen. Stat. § 131E-91 (Fair billing and collections practices) - Requires hospitals to provide an itemized list of charges upon request and explains timing and billing practices.
• N.C. Gen. Stat. § 90-411 (Record copy fee) - Addresses what a provider may charge to copy medical records when you request them.
• N.C. Gen. Stat. § 44-49 (Medical provider lien; itemized statement on request) - Creates a lien tied to personal injury recoveries and requires an itemized statement/records and lien notice to be provided to the injured person’s attorney upon request as a condition to the lien.

Analysis

Apply the Rule to the Facts: Here, the provider says the hospital and any physician-related billing for the ER date of service were processed through health coverage and the account shows a zero balance. Even so, the cleanest way to confirm nothing is missing is to (1) obtain the hospital’s itemized charge detail and (2) separately confirm whether any professional groups billed for that same date of service, and if so, obtain their itemized statements or written confirmation that no separate professional bill exists.

Process & Timing

1. Who files: The patient or the patient’s authorized representative (often the attorney with a signed authorization). Where: The hospital billing office (for facility charges) and each separate professional billing office (for physician/radiology/lab professional fees) in North Carolina. What: Request (a) a free itemized hospital bill for the date of service and (b) itemized professional statements (or “paid in full/zero balance” letters) from any separate billers. When: For the hospital itemized list, North Carolina law allows a request within three years after discharge (and sometimes longer if the hospital or an assignee still claims you owe the bill).
2. Match services to billers: Compare the hospital itemized charges to the clinical services you know occurred (for example, imaging performed). If the hospital shows imaging charges but you never received a radiology interpretation bill, ask whether the interpretation was billed separately or included.
3. Close the loop in writing: If the hospital insists everything is processed and zero balance, ask for a short written confirmation stating whether the hospital statement includes only facility charges and listing any separate professional entities involved (or confirming none were involved).

Exceptions & Pitfalls

• “Zero balance” does not always mean “no separate bills”: A hospital account can be zero while a separate emergency physician or radiology group billed insurance under a different account number.
• Facility vs. professional charges get confused: Imaging often has a technical component (equipment/use) and a professional component (interpretation). You may need to request both sides to confirm completeness.
• Insurance EOBs can help, but they are not the same as itemized bills: An explanation of benefits may show who billed, but it may not list the same detail you need for a claim file.
• Authorization problems slow everything down: If you are requesting on someone else’s behalf, missing or incomplete HIPAA authorizations can lead to delays or partial responses.
• Lien paperwork can be incomplete: In injury cases, if a provider later asserts a lien, confirm whether they provided the required itemized statement/records and written lien notice upon request before treating it as a valid lien claim.

Conclusion

In North Carolina, if you think you are missing a separate emergency physician or radiology bill from an ER visit, request a free itemized hospital bill for that date of service and ask the hospital to identify any separately billing professional groups. Then request each group’s itemized professional statement (or written confirmation that no separate professional claim exists). As a next step, request the hospital’s itemized list within three years after discharge.

Talk to a Personal Injury Attorney

If you’re dealing with questions about missing ER bills (hospital charges versus separate physician or radiology charges) while a claim is being evaluated, our firm has experienced attorneys who can help you understand what to request, how to organize the paperwork, and what timelines to watch. Reach out today. Call [CONTACT NUMBER].

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.