Short Answer

Under North Carolina law and federal privacy rules, a hospital must provide access to billing records— including an itemized statement—within 30 days after receiving a valid written request with proper authorization. The hospital may take one additional 30-day extension, but it must send a written notice explaining the delay and giving a new due date. Many facilities respond sooner, but the 30-day clock controls. If the request was made only by phone or the authorization was incomplete, the clock may not have started.

Understanding the Problem

In North Carolina, how quickly can an attorney obtain a hospital’s itemized billing statement after submitting valid medical billing authorizations and a written request on a client’s personal injury matter? You want to know when the hospital must produce the detailed charges so you can evaluate claims and liens.

Apply the Law

Hospitals must provide patients (and their authorized representatives) access to billing records, including an itemized statement, upon a valid written request. The main offices involved are the hospital’s Health Information Management (Medical Records) and Patient Financial Services (Billing). The core timing rule is a 30-day response period from receipt of a proper request, with one possible 30-day written extension. Providers may charge reasonable copy fees allowed by law.

Key Requirements

• Valid authorization: A HIPAA-compliant authorization that clearly permits release of billing records to the requesting attorney.
• Specific request: Ask for an “itemized billing statement” and identify the date(s) of service to avoid a summary bill.
• Right office: Send the request to Health Information Management (Medical Records) or Patient Financial Services (Billing), per the hospital’s instructions.
• Timing: Hospital must respond within 30 days of receiving a proper request; one additional 30-day extension is allowed only with written notice stating the reason and new due date.
• Fees and format: Reasonable copy/processing fees may apply; electronic delivery is often available and can be faster.

What the Statutes Say

• HIPAA Right of Access (45 C.F.R. § 164.524) - Patients (and authorized representatives) must be given access to records, including billing records, within 30 days; one written 30-day extension allowed.
• N.C. Gen. Stat. § 44-49 (Medical provider lien) - Addresses provider lien rights in injury cases and reinforces access to records and itemized charges upon request.
• N.C. Gen. Stat. § 44-50 (Payment of liens) - Governs payment from settlements and works alongside § 44-49 when obtaining itemized charges.
• N.C. Gen. Stat. § 90-411 (Medical records fees) - Allows reasonable charges for copies of medical records; some providers apply similar fees to billing records.

Analysis

Apply the Rule to the Facts: Because the firm already sent medical billing authorizations and requested the itemized statement, the hospital should produce the itemized charges within 30 days of receiving that proper written request. If the hospital needs more time, it must send a written extension notice with a reason and a new date. If the request was made only by phone or sent to the wrong office, re-send a written, HIPAA-compliant request to start the 30-day clock.

Process & Timing

1. Who files: The patient or the attorney with a HIPAA-compliant authorization. Where: Hospital Health Information Management (Medical Records) or Patient Financial Services (Billing) in North Carolina. What: A written request for an “itemized billing statement” for the specific date(s) of service, with a valid authorization. When: Upon receipt, the hospital has 30 days to respond; one written 30-day extension is allowed.
2. Follow up in 10–14 days to confirm receipt and processing. If delayed, ask for written confirmation of any extension with the expected completion date. Local processing times can vary by facility.
3. Receive the itemized statement by secure email, portal, mail, or fax. Verify all dates of service and charges; if something is missing, submit a clarified, written follow-up.

Exceptions & Pitfalls

• Incomplete authorization (missing required elements or signatures) can pause the clock until corrected.
• Requesting a generic “bill” instead of an “itemized billing statement” may yield only a summary and require a new request.
• Sending the request to the wrong department (e.g., general customer service) can delay processing; use HIM/Medical Records or Patient Financial Services.
• Not specifying the date(s) of service can cause the hospital to search multiple accounts, slowing the response.
• Some facilities require their own release form; if so, submit it promptly to avoid restarts.

Talk to a Personal Injury Attorney

If you're waiting on an itemized hospital bill for a North Carolina injury claim, our firm can help you make a proper request, track deadlines, and resolve billing issues. Reach out today. Call (919) 341-7055.

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.