Kentucky Statutes 216B.250 – Health facility to furnish itemized statement of charges on request of paying patient
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(1) For purposes of this section, “paying patient” means persons receiving health care services who pay directly for services rendered, patients with private health insurance or health maintenance organization coverage, persons receiving Medicaid or Medicaid benefits under Title XVIII and Title XIX of the Social Security Act and persons receiving veteran’s health care benefits. “Paying patient” does not include medically indigent persons with no source of payment whatsoever.
(2) (a) When a copy of an itemized statement is requested by any paying patient, each health facility shall furnish to the patient within thirty (30) days of the patient’s discharge or within fifteen (15) days of the patient’s request, whichever is later, one (1) copy free of charge of the itemized statement of services rendered and charges incurred by the patient.
(b) A summary statement of services rendered and charges incurred by the patient shall be included with the invoice sent by a health facility to the patient. Each invoice shall indicate that an itemized statement may be obtained upon request. The Cabinet for Human Resources shall impose a civil fine of five hundred dollars ($500) for each violation by a health care facility for failure to provide an itemized statement as required under this section.
(c) The itemized statement shall be stamped “Kentucky Revised Statutes prohibit the use of this statement for insurance payment purposes where benefits have been assigned.”
(3) Each health facility shall post in a publicly visible place in their admission, outpatient areas and, where applicable, emergency areas that an itemized statement is available to any paying patient upon request.
(4) The itemized statement rendered shall be the record maintained by the health facility that details the charges made for services rendered to patients and shall indicate whether an assignment of benefits has been obtained.
(5) Each health facility shall designate and make available appropriate staff to provide, upon patient request, an explanation of charges listed in the itemized statement.
(6) If a health facility knows of a discrepancy in the total charges as reported in an itemized statement and that which is reported to a third party payor, or at any time that a health facility becomes aware of such a discrepancy, the health facility shall provide the patient and third party payor with notification, an explanation and, if applicable, any reconciliation of the discrepancy in total charges.
Effective: April 10, 1998
History: Amended 1998 Ky. Acts ch. 496, sec. 57, effective April 10, 1998. — Created
1986 Ky. Acts ch. 288, sec. 1, effective July 15, 1986.
(2) (a) When a copy of an itemized statement is requested by any paying patient, each health facility shall furnish to the patient within thirty (30) days of the patient’s discharge or within fifteen (15) days of the patient’s request, whichever is later, one (1) copy free of charge of the itemized statement of services rendered and charges incurred by the patient.
(b) A summary statement of services rendered and charges incurred by the patient shall be included with the invoice sent by a health facility to the patient. Each invoice shall indicate that an itemized statement may be obtained upon request. The Cabinet for Human Resources shall impose a civil fine of five hundred dollars ($500) for each violation by a health care facility for failure to provide an itemized statement as required under this section.
(c) The itemized statement shall be stamped “Kentucky Revised Statutes prohibit the use of this statement for insurance payment purposes where benefits have been assigned.”
(3) Each health facility shall post in a publicly visible place in their admission, outpatient areas and, where applicable, emergency areas that an itemized statement is available to any paying patient upon request.
(4) The itemized statement rendered shall be the record maintained by the health facility that details the charges made for services rendered to patients and shall indicate whether an assignment of benefits has been obtained.
(5) Each health facility shall designate and make available appropriate staff to provide, upon patient request, an explanation of charges listed in the itemized statement.
(6) If a health facility knows of a discrepancy in the total charges as reported in an itemized statement and that which is reported to a third party payor, or at any time that a health facility becomes aware of such a discrepancy, the health facility shall provide the patient and third party payor with notification, an explanation and, if applicable, any reconciliation of the discrepancy in total charges.
Effective: April 10, 1998
History: Amended 1998 Ky. Acts ch. 496, sec. 57, effective April 10, 1998. — Created
1986 Ky. Acts ch. 288, sec. 1, effective July 15, 1986.