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Billing Itemization Required?

January 31, 2017

By: Jon Jablon, Esq.

Question: is a medical provider required to give an itemization as part of the billing? Answer: Generally no. Texas and Florida have passed legislation requiring them in certain instances, but often TPAs and plans must make the arguments that (1) the bill is not complete or “clean” without an itemization, and (2) the itemization is part of the medical record, which the patient is entitled to pursuant to HIPAA.