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Texas Statutes (Last Updated: January 4, 2014) |
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HEALTH AND SAFETY CODE |
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Title 4. HEALTH FACILITIES |
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Subtitle F. POWERS AND DUTIES OF HOSPITALS |
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Chapter 311. POWERS AND DUTIES OF HOSPITALS |
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Subchapter A. GENERAL PROVISIONS |
Sec. 311.002. ITEMIZED STATEMENT OF BILLED SERVICES
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(a) Each hospital shall develop, implement, and enforce a written policy for the billing of hospital services and supplies. The policy must include:
(1) a periodic review of the itemized statements required by Subsection (b); and
(2) a procedure for handling complaints relating to billed services.
(b) Not later than the 30th business day after the date of the hospital discharge of a person who receives hospital services, the hospital shall provide on request an itemized statement of the billed services provided to the person. The itemized statement must:
(1) be printed in a conspicuous manner;
(2) list the date services and supplies were provided;
(3) state whether:
(A) a claim has been submitted to a third party payor; and
(B) a third party payor has paid the claim;
(4) if payment is not required, state that payment is not required:
(A) in a typeface that is bold-faced, capitalized, underlined, or otherwise set out from surrounding written material; or
(B) by other reasonable means so as to be conspicuous that payment is not required; and
(5) contain the telephone number of the facility to call for an explanation of acronyms, abbreviations, and numbers used to describe the services provided or supplies used or any other questions regarding the bill.
(c) Before a person is discharged from a hospital, the hospital shall inform the person of the availability of the statement.
(d) To be entitled to receive a statement, a person must request the statement not later than one year after the date on which the person is discharged from the hospital. The hospital shall provide the statement to the person not later than the 30th day after the date on which the person requests the statement.
(e) A hospital shall provide an itemized statement of billed services to a third party payor who is actually or potentially responsible for paying all or part of the billed services provided to a patient and who has received a claim for payment of those services. To be entitled to receive a statement, the third party payor must request the statement from the hospital and must have received a claim for payment. The request must be made not later than one year after the date on which the payor received the claim for payment. The hospital shall provide the statement to the payor not later than the 30th day after the date on which the payor requests the statement. If a third party payor receives a claim for payment of part but not all of the billed services, the third party payor may request an itemized statement of only the billed services for which payment is claimed or to which any deduction or copayment applies.
(f) If a person, including a third party payor, requests more than two copies of the statement, the hospital may charge a reasonable fee for the third and subsequent copies provided to that person. The fee may not exceed the hospital's cost to copy, process, and deliver the copy to the person.
(g) The Texas Department of Health or other appropriate licensing agency may enforce this section by assessing an administrative penalty, obtaining an injunction, or providing any other appropriate remedy, including suspending, revoking, or refusing to renew a hospital's license.
(h) In this section, "hospital" includes:
(1) a treatment facility licensed under Chapter 464; and
(2) a mental health facility licensed under Chapter 577.
(i) This section does not apply to a hospital maintained or operated by the federal government.