For healthcare providers and billing teams operating in Texas, there are upcoming changes to required medical billing practices that may apply before past-due accounts can be referred to a collection agency.
Texas SB 490 was signed into law by Governor Greg Abbott on May 29, 2023, and is scheduled to take effect on September 1, 2023. The bill is titled Health Care Billing.
Itemized bill requirement
Section 185.002 of SB 490 requires a provider requesting payment from a patient after providing services or related supplies to submit a written, itemized bill of the alleged cost of each service and supply provided during the patient’s visit.
Timing
- The itemized bill must be submitted no later than the 30th day after the provider receives a final payment from a third party for the provided service or supply (when applicable).
What the itemized bill must include
- A plain-language description of each distinct health care service or supply provided.
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If the provider sought or is seeking reimbursement from a third party, the statement must include:
- Any billing code submitted to the third party; and
- The amounts billed to and paid by that third party.
- The amount the provider alleges is due from the patient for each service and supply provided.
Electronic delivery and patient requests
- A provider may issue the itemized bill electronically, including through a patient portal on the provider’s website.
- A patient is entitled to obtain an itemized bill on request at any time after the itemized bill is initially issued.
Collections limitation
SB 490 states that a provider may not pursue debt collection against a patient for a provided health care service or supply unless the provider has complied with this section.
Implementation note
This post is provided for general informational purposes only and is not legal advice. Providers may want to consult with their billing company and/or attorney for guidance on implementation and compliance with SB 490.