Short Answer

In North Carolina, most EMS providers covered by HIPAA must respond to a valid request for billing records or an EMS patient care report within 30 days of receiving it. They may take one 30-day extension if they send a written notice explaining the delay. The clock typically starts when the provider receives a complete request with proper authorization and enough details to locate the record.

Understanding the Problem

You want to know how long a North Carolina EMS provider can take to send billing and EMS run records. As the requesting party (patient or attorney), can you expect a quick turnaround, and what affects the timing? Here, a personal injury attorney requested a client’s EMS billing balance and records and was told a HIPAA authorization or power of attorney is required to release billing information.

Apply the Law

Under North Carolina law, EMS billing statements and patient care reports are medical records. Providers must have lawful authority to release them, usually a HIPAA-compliant authorization signed by the patient or a legally authorized representative. The primary forum is the EMS provider’s records or legal department (or its third-party release-of-information vendor). Federal privacy rules require a response within 30 days after receipt of a valid, sufficiently specific request; one 30-day extension is allowed with written notice. North Carolina law also permits reasonable copy and retrieval fees for medical records.

Key Requirements

• Valid authority: Include a HIPAA-compliant authorization signed by the patient or documents showing legal authority (e.g., health care agent or personal representative).
• Specificity to locate records: Provide details like patient name, date of birth, date of service, provider name, and any run number or request number.
• Use the required channel: Submit through the EMS provider’s designated portal or its records/legal department as instructed.
• Timing rule: The provider must respond within 30 days of receiving a complete request; one written 30-day extension is permitted.
• Fees: Be prepared to pay allowable copy/retrieval fees before release, if the provider requires it.

What the Statutes Say

• HIPAA Privacy Rule, 45 C.F.R. § 164.524 (Right of access) - 30-day response time, with one 30-day extension by written notice.
• N.C. Gen. Stat. § 90-411 (Fees for copies of medical records) - Allows reasonable fees for copies and related services.
• N.C. Gen. Stat. § 8-44.1 (Medical records as business records) - Addresses use of medical records and bills; often relevant to obtaining certified records.

Analysis

Apply the Rule to the Facts: Here, the EMS provider required a HIPAA authorization or power of attorney before releasing billing information. That aligns with the valid-authority requirement. Their automated system asked for a run number and date of service, which are the specificity details that start the 30-day clock once received. Because the legal department directed requests through the provider’s online portal or records office and warned to include the patient name, DOB, provider name, request number, and attorney contact, the 30-day response period will generally begin when those items and the signed authorization arrive through the correct channel.

Process & Timing

1. Who files: The patient or the attorney with a signed HIPAA authorization (or legally authorized representative). Where: The EMS provider’s online portal or records/legal department in North Carolina. What: Submit the provider’s records request form or a HIPAA-compliant authorization, plus patient name, date of birth, provider name, date of service, run number, request number, and attorney contact details. When: The provider must respond within 30 days of receiving a complete, valid request; they may take one written 30-day extension.
2. Provider acknowledges the request and may invoice allowable copy/retrieval fees. Many EMS vendors fulfill standard requests in about 10–20 business days, but timeframes vary by county and workload.
3. Records are delivered via secure portal, encrypted email, or mailed media. Expect the EMS patient care report and itemized billing; certified copies may add processing time.

Exceptions & Pitfalls

• Missing or defective authorization (no signature, expired form, wrong patient) can pause processing until corrected.
• Insufficient identifiers (no date of service or run number) may prevent the provider from locating the record, delaying the 30-day clock.
• Using the wrong channel (emailing the wrong department instead of the designated portal) can lead to re-routing and lost time.
• Unpaid copy/retrieval fees may hold up release until payment posts.
• Special situations (minor patients, deceased patients, or court orders) may require additional documentation before release.

Talk to a Personal Injury Attorney

If you're dealing with delays getting EMS billing or run records, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at 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.