Short Answer

Start by pulling every Explanation of Benefits (EOB) from your health insurer and itemized statements from each medical provider. In North Carolina, the at-fault driver’s insurer usually reimburses medical bills through a settlement, not “as you go,” while your own health insurance and any auto Medical Payments (MedPay) coverage may pay earlier. Confirm any liens and balances directly with providers, because medical providers can claim part of your settlement by statute. Get written zero-balance confirmations before you close your claim.

Understanding the Problem

You want to know whether insurance has actually paid your accident-related medical bills in North Carolina, and how to confirm if anything is still owed. You saw a small copay on one visit that you thought should have been covered. The core question is: how do you check what your health insurance, your own auto policy, and the at-fault insurer have paid—and make sure no bills remain?

Apply the Law

Under North Carolina law, your health insurer may process treatment and apply copays, coinsurance, or deductibles. Your auto policy may include MedPay that pays medical expenses regardless of fault, up to your limit. The at-fault carrier generally pays later in a lump-sum settlement. Medical providers have statutory lien rights against personal injury recoveries, and certain public benefits (like Medicaid) require reimbursement from settlements. The main “forums” are your insurers’ claims departments and your medical providers’ billing offices; medical liens must be addressed before settlement funds are disbursed. A key threshold: North Carolina caps the total that medical providers can take from a settlement under medical liens.

Key Requirements

• Identify all payers: Health insurance, your auto MedPay (if purchased), and the at-fault driver’s liability insurer (typically via settlement).
• Verify payments and balances: Match EOBs against itemized provider statements to see what was billed, allowed, paid, and what you owe.
• Account for liens/reimbursement: North Carolina medical providers may assert liens on your settlement; Medicaid and some plans require reimbursement.
• Resolve before disbursement: Lien claims must be addressed before settlement funds are paid out; providers’ total lien recovery is capped by statute.
• Notice and timing: MedPay and insurer policies often require prompt notice and documentation to pay benefits.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider liens on personal injury recoveries) - allows providers to claim a lien for reasonable medical charges related to the injury.
• North Carolina Gen. Stat. § 44-50 (Payment of liens; cap) - limits the total amount payable to medical lienholders from a settlement.
• North Carolina Gen. Stat. § 108A-57 (Medicaid lien and recovery) - requires reimbursement to Medicaid from third-party settlements.

Analysis

Apply the Rule to the Facts: You have a personal injury claim and are reviewing bills. First, pull your health insurer’s EOBs and provider itemized statements to confirm what was allowed and what remains—your small copay may be normal cost-sharing. Next, check your auto policy for MedPay and submit your bills if available. Finally, do not assume the at-fault insurer has paid providers; in North Carolina, you typically resolve medical liens and balances at settlement, subject to the statutory cap.

Process & Timing

1. Who files: You (or your attorney). Where: Health insurer member portal and claims department; each provider’s billing office; your auto insurer’s MedPay unit; at-fault insurer’s adjuster. What: Request all EOBs; get itemized statements and current balances; submit bills and proof of treatment to MedPay; ask for any lien or reimbursement notices. When: Do this as soon as treatment bills post; MedPay claims often require prompt notice under your policy.
2. Reconcile records: Match each provider charge to an EOB and payment. If health insurance denied or underpaid, ask the provider to re-bill with correct codes or submit an internal appeal within the plan’s appeal window (deadlines vary by plan).
3. Close the loop: Before settlement disburses, obtain written lien amounts and negotiate/resolution as allowed by law. Then collect written zero-balance confirmations from every provider and plan asserting reimbursement.

Exceptions & Pitfalls

• Some health plans (for example, certain employer self-funded plans) may claim reimbursement rights beyond state rules—get plan documents and written amounts early.
• Unmatched bills: providers may bill under different facility and professional accounts; request itemized statements for each to avoid missed balances.
• Duplicate payments: if MedPay or health insurance pays, the at-fault settlement still includes those medical expenses, but liens/reimbursement must be addressed to prevent chargebacks.
• Incorrect coding or out-of-network status can cause denials; ask providers to correct and re-submit rather than paying an inflated bill.
• Do not assume the at-fault insurer “pays as you go”; in North Carolina, those payments usually come only at settlement.

Talk to a Personal Injury Attorney

If you're dealing with confusing EOBs, MedPay questions, or medical liens after an accident, 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.