North Carolina
Limitations on Charges, Billing, and Collections
North Carolina requires hospitals to provide to discharged patients an itemized list of charges upon request, as well as abide by reasonable collection practices.

Hospitals must provide an itemized list of charges to a patient upon request. A patient may request an itemized list at any time within three years after the date of discharge. N.C. Gen. Stat. §131E-91(a) (2013). Hospitals are also required to establish a method for patients to inquire about or dispute a bill. N.C. Gen. Stat. §131E-91(a) (2013). A hospital may not bill insured patients for charges that would have been covered by their insurance if the hospital had submitted the claim within the allotted time requirements. N.C. Gen. Stat. §131E-91(c) (2013).

Hospitals must also follow reasonable collection practices. Hospitals may not send a patient’s unpaid bill to collections while a decision on the patient’s charity care application is pending or attach a lien to a patient’s principal residence. N.C. Gen. Stat. §131E-91(d). Patients must be given written notice that their bill will be subject to collections activity at least 30 days prior to the referral for collection being made. N.C. Gen. Stat. §131E-91(d) (2013).