Short Answer

In North Carolina, you have the right to request an itemized hospital bill and the medical records tied to your injury claim. If the hospital refuses or stalls, send a written, HIPAA-compliant request to the hospital’s Health Information Management or Patient Financial Services office and track receipt. Hospitals generally must respond to records requests within 30 calendar days under federal HIPAA rules, and North Carolina law conditions a hospital’s lien rights on making bills and records available upon request. If delays continue, escalate in writing and consider filing a complaint.

Understanding the Problem

You’re asking, in North Carolina, what you can do if a hospital will not send the itemized bill you need to support a personal injury claim. You (or your attorney) want the hospital to provide an itemized statement that breaks down each charge. Here, you already asked the hospital to fax the itemized bill. The key issue is whether, when, and how you can compel a timely response so your claim is not delayed.

Apply the Law

Under North Carolina law and federal privacy rules, patients (or their authorized representatives) can request an itemized bill and medical records related to treatment. Hospitals typically route billing questions to Patient Financial Services and records to Health Information Management (Medical Records). HIPAA generally gives providers 30 calendar days to respond to records requests. North Carolina also ties a provider’s medical lien on your settlement to cooperating with requests for related bills and records.

Key Requirements

• Valid written request and authorization: Make the request in writing, identify the patient and dates of service, and include a signed HIPAA authorization if you are not the patient.
• Ask for an “itemized statement” of charges: Specify that you need the itemized bill (line-by-line charges) for the dates of service, not just a balance summary.
• Response time: Providers generally must respond to medical-records requests within 30 calendar days of receipt; one extension may apply if they explain the delay in writing.
• Reasonable copy fees: North Carolina limits what providers can charge for copies of medical records; fees do not excuse failure to respond.
• Hospital lien cooperation: A North Carolina hospital’s lien on any settlement depends on making relevant bills and records available upon request.

What the Statutes Say

• N.C. Gen. Stat. § 44-49 (Medical liens) - Hospitals must make related bills and records available upon request to preserve a lien on your injury recovery.
• N.C. Gen. Stat. § 90-411 (Medical record copy fees) - Sets limits on what providers can charge for copies of medical records.
• 45 C.F.R. § 164.524 (HIPAA right of access) - Requires covered entities to provide access to records within 30 days, with a possible written extension.

Analysis

Apply the Rule to the Facts: You asked the hospital to fax an itemized bill after an accident stay. To hold the hospital to a timeline, convert that request into a written, trackable submission to Medical Records/Patient Financial Services with a HIPAA authorization. That starts the HIPAA 30-day response clock. If the hospital plans to assert a lien on your settlement, North Carolina law expects them to make the related bill and records available when requested.

Process & Timing

1. Who files: The patient or the patient’s attorney. Where: Hospital Health Information Management (Medical Records) and Patient Financial Services in North Carolina. What: A written request for the “itemized statement of charges” for the specific dates of service, plus a HIPAA authorization. If available, use the hospital’s records request form posted on its website or patient portal. When: Send immediately; HIPAA generally requires a response within 30 calendar days of the hospital receiving your request.
2. Follow up: Confirm receipt within 3–5 business days. If no response by day 20, escalate in writing to the Patient Accounts manager and HIM director and request a delivery date. Document every contact.
3. If still delayed/refused: Send a final written demand referencing your HIPAA access request and that North Carolina lien law requires providers to make related bills and records available upon request. If no response by day 30 (or by any stated extension date), consider filing a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, and report the issue to the N.C. Division of Health Service Regulation. Expected outcome: production of the itemized bill.

Exceptions & Pitfalls

• Oral requests stall: Phone calls alone rarely trigger the HIPAA clock. Submit a written request and keep proof of delivery.
• Authorization issues: If you are not the patient, an incomplete or expired HIPAA authorization can pause processing. Include the patient’s full name, DOB, dates of service, your contact info, and a fresh signature.
• Wrong department: Billing and records are often separate. Send the request to both Patient Financial Services (for the itemized statement) and HIM/Medical Records (for records).
• Fees confusion: Providers may charge limited copy fees for records, but that does not excuse non-response. Ask for the itemized statement first; it is typically provided without a copy fee.
• Lien leverage: If the hospital asserts a lien on your settlement, failure to make bills/records available upon request can affect lien enforcement. This helps with leverage but does not replace making a proper, trackable request.

Talk to a Personal Injury Attorney

If you’re facing delays getting an itemized hospital bill for your claim, our firm has experienced attorneys who can help you understand your options and timelines. Reach out today.

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.