Short Answer

In North Carolina, you can request a free, itemized list of charges from the hospital for a specific emergency-room date of service. State law requires hospitals to provide an itemized list of charges upon the patient’s request, and you generally have up to three years after discharge to ask for it. If you also want to confirm separate emergency-physician (professional) charges, you usually need to request those directly from the physician billing group (or confirm them through your health plan’s Explanation of Benefits).

Understanding the Problem

If you had an emergency-room visit in North Carolina and the account now shows a zero balance, you may still want an itemized statement tied to that date of service so you can confirm what was billed (and whether there were separate hospital charges versus emergency-physician charges). The practical question is: can you request a detailed breakdown for that specific ER date even when insurance processed the claim and you do not currently owe anything?

Apply the Law

North Carolina law requires hospitals (and ambulatory surgical facilities) to provide an itemized list of charges when the patient requests it. The itemized list should describe the specific nature of the charges in language an ordinary person can understand. The request window is broad: you can request the itemized list at any time within three years after discharge (and sometimes longer if the facility or a collector is still asserting you owe the bill). Separately, if what you need is not a “bill” but supporting documentation (like medical records or certain billing-related records kept with the chart), North Carolina also allows providers to charge regulated copy fees for medical records requests.

Key Requirements

• Request by (or for) the patient: The hospital’s duty to provide an itemized list is triggered by a patient request (or a request made on the patient’s behalf with appropriate authorization).
• Ask for the “itemized list of charges” for the date of service: Use the ER date of service and discharge date so the billing office can pull the correct account/encounter.
• Timing matters: You generally have up to three years after discharge to request the itemized list of charges from the hospital.
• Hospital charges vs. professional charges: The hospital’s itemized list typically covers the facility’s charges; emergency physicians often bill separately as professional services, which may require a separate request to the physician billing entity.
• Know what you’re requesting: An itemized bill is different from medical records; medical-record requests can involve copy fees and different processing steps.

What the Statutes Say

• N.C. Gen. Stat. § 131E-91 (Fair billing and collections practices) - Requires hospitals to provide, upon request and free of charge, an itemized list of charges; allows requests within three years after discharge (and in some situations longer).
• N.C. Gen. Stat. § 90-411 (Record copy fee) - Allows health care providers to charge regulated fees for copying medical records when you request records (which may be different from an itemized bill).
• N.C. Gen. Stat. § 131E-97 (Confidentiality of patient information) - Clarifies that patient medical and billing/financial records held by facilities are not public records.

Analysis

Apply the Rule to the Facts: Here, the goal is to confirm whether the ER visit generated separate facility and physician-related charges and whether anything is missing, even though the provider says the account is at a zero balance after health coverage processed it. Under North Carolina law, the hospital must provide an itemized list of charges if the patient requests it, and the request can generally be made within three years after discharge. Because emergency physicians often bill separately from the hospital, you may need a second, separate request to the physician billing entity (or your health plan) to confirm professional charges tied to the same date of service.

Process & Timing

1. Who files: The patient (or the patient’s authorized representative). Where: The hospital’s billing office / patient financial services department in North Carolina. What: A written request for a free itemized list of charges for the specific ER date of service (include patient name, date of birth, date of service, and account/encounter number if available). When: Submit it as soon as possible and, in most cases, no later than three years after discharge.
2. Confirm professional (physician) billing: Ask the hospital billing office for the name and contact information of the emergency physician billing entity for that date, then request an itemized statement from that entity as well. If the provider says everything ran through health coverage, also request the health plan’s Explanation of Benefits (EOB) for that date of service to see which entities billed and what codes/amounts were processed.
3. Reconcile and follow up: Compare (a) the hospital’s itemized list, (b) any physician/professional itemization, and (c) the EOB(s). If something appears missing (for example, radiology or pathology professional fees), ask for clarification in writing and keep a record of who you spoke with and when.

Exceptions & Pitfalls

• “Zero balance” does not always mean “no charges existed”: It can mean the claim was paid/adjusted, written off, or otherwise resolved, but you may still need the itemized charge detail for documentation purposes.
• Facility vs. professional billing confusion: The hospital’s itemized list may not include separate professional bills (emergency physician, radiology, pathology). If you only request from the hospital, you may miss professional statements.
• Asking the wrong department: Medical Records (HIM) and Billing are often separate. If you request “records,” you may be routed into a medical-records process with copy fees; if you want the itemized list of charges, direct the request to billing/patient financial services.
• Authorization gaps: If a law firm is requesting on the client’s behalf, the provider may require a signed authorization or other proof of representation before releasing billing detail.
• Incomplete identifiers: Without the correct date of service, discharge date, and encounter/account number, facilities may provide the wrong visit’s billing detail or a summary instead of an itemized list.

Conclusion

In North Carolina, you can request a free itemized list of charges from the hospital for a specific emergency-room date of service, even if insurance processed the claim and the account shows a zero balance. The key threshold is making the request within three years after discharge. Next step: submit a written request to the hospital’s billing office for the itemized list of charges for that ER date of service within three years of discharge.

Talk to a Personal Injury Attorney

If you’re dealing with an injury claim and need to confirm all ER-related charges for a specific date of service (including separate hospital and physician billing), our firm has experienced attorneys who can help you understand your options and timelines. 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.