In North Carolina, the most useful documents to confirm which accident-related medical bills your health insurance actually paid are your Explanation of Benefits (EOBs) (or an insurer paid-claims history) and the provider’s itemized bills that match those EOBs. You will usually also need a HIPAA medical authorization and a plan/insurance information sheet (member ID, claim numbers, and dates of service) so the health plan or its recovery vendor can pull the correct records. If your case is already settled, a copy of the settlement paperwork is often requested to confirm the injury date, parties, and recovery amount.
In North Carolina, if your health plan (or its recovery vendor) is asking you to confirm which accident-related medical bills were paid, the question is usually: “What paperwork shows what the insurer paid versus what the provider billed?” This comes up most often after a settlement, because the health plan may claim a right to be repaid from the settlement for certain payments. In your situation, one key fact is that the at-fault insurance claim has already been settled.
North Carolina law recognizes several types of reimbursement and lien rights that can affect injury settlements, including medical provider liens and certain government or state-plan recovery rights. The practical issue is proof: the health plan (or its vendor) typically needs documents that (1) identify the accident and the covered person, (2) list the medical charges tied to the injury, and (3) show what the plan actually paid (not just what was billed). There is no single universal “North Carolina form” for private health-plan subrogation; the documents needed depend on the plan type (private plan, State Health Plan, Medicaid, etc.) and the plan’s written terms.
Apply the Rule to the Facts: Because your motor-vehicle claim has already settled and your firm is opening a file with a health-plan recovery vendor, the vendor will usually want documents that let them (1) identify the accident date and the covered person, (2) confirm which providers treated you for back pain/headaches after the collision, and (3) verify what the health plan actually paid for that treatment. EOBs (or a paid-claims history) are the cleanest proof of payment, and itemized provider bills help match each payment to a specific date of service and charge.
To confirm which accident-related medical bills your health insurance paid in North Carolina, you typically need EOBs (or a paid-claims history) plus the providers’ itemized bills that match those EOBs, along with a HIPAA authorization and your plan/claim identifiers. Because your liability claim is already settled, the recovery vendor will often also request the settlement paperwork to confirm the accident date and recovery details. Next step: request a paid-claims history from your insurer and provide it to the vendor promptly (and if Medicaid is involved, watch the 30-day notice window).
If you’re dealing with a health-plan reimbursement/subrogation request after an accident settlement, our firm has experienced attorneys who can help you gather the right documents, confirm what was actually paid, and understand the timelines that may apply. Reach out today at [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.