Navigating Texas Medical Debt Laws: How to Manage Unpaid Bills and Protect Your Practice

With billions in medical debt affecting U.S. providers annually, Texas healthcare providers face their own unique challenges with unpaid bills. According to the American Hospital Association (AHA), uncollected medical payments are a significant issue, while the Kaiser Family Foundation reports that 41% of U.S. adults have medical debt. This blog will guide Texas healthcare providers on navigating state-specific laws regarding unpaid medical bills and reclaiming lost revenue.

This in-depth guide explains the primary Texas laws on medical debt collection and provides insight into how healthcare providers can secure timely payments.

Key Texas Laws on Unpaid Medical Bills

Here are the three essential laws governing unpaid medical bills in Texas, and how they impact the way providers should approach collections:

1. Timely Billing and Notification Requirements

The Texas Civil Practice & Remedies Code §146.002 mandates that providers bill patients or responsible parties by the first day of the 11th month following the date of service. If the provider bills an insurance company, the timeline can be adjusted per the insurance contract terms. For third-party payers like Medicare or Medicaid, federal guidelines take precedence unless no contract exists, in which case the 11-month rule applies.

2. Statute of Limitations for Medical Debt Collection

According to Texas Civil Practice & Remedies Code §16.004, providers have up to four years from the service date to file a lawsuit for unpaid bills. However, while the debt remains even after four years, it can no longer be legally pursued through the court. Providers can still report the unpaid balance to credit bureaus, which can affect the patient’s credit score.

3. Itemized Billing Requirements

Texas Health and Safety Code §185.001 mandates that providers submit an itemized bill within 30 days after receiving final payment from a third party. If a patient or third-party fails to pay, providers must send three physical statements detailing the charges before the debt can be sent to collections. The itemized bill serves as proof of the services rendered, aiding in both the billing and collection processes.

How to Stay Ahead of Unpaid Medical Bills

Successfully managing unpaid bills requires a proactive approach to both patient care and revenue cycle management. With the increasing complexity of healthcare billing, many providers find it challenging to manage billing while prioritizing patient care.

By partnering with medical billing companies like Sirius Solutions Global, healthcare providers can reduce the stress of managing unpaid bills. Sirius Solutions Global’s compliance team stays updated on Texas billing laws, ensuring providers meet deadlines and avoid compliance issues.

Why Choose Sirius Solutions Global for Billing Support?

Specialized Knowledge: Sirius Solutions Global’s team has extensive knowledge of Texas laws on medical billing. They ensure your practice adheres to filing deadlines and understands how to manage billing efficiently.
Technology-Driven Efficiency: Utilizing advanced automation, Sirius Solutions Global helps providers track deadlines and create itemized bills with ease. Their technology minimizes human error and ensures timely submission.
Streamlined Communication: Sirius Solutions Global employs effective patient communication strategies, helping reduce unpaid bills and encouraging prompt payment. They also handle patient inquiries, freeing up time for providers to focus on care.

Conclusion

Texas laws on medical billing protect both providers and patients by ensuring transparency and clear guidelines. By partnering with a medical billing expert like Sirius Solutions Global, providers can effectively manage unpaid bills while adhering to state regulations. This partnership enables providers to focus on quality care while Sirius Solutions Global handles the complexities of billing, compliance, and collections, ultimately improving the financial health of the practice.