§ 146.002.Timely Billing Required

A billing deadline, expressed as a date rather than a period.

The general rule (subsection (a)): a provider shall bill a patient or other responsible person not later than the first day of the 11th month after the date the services are provided.

That is roughly ten months, and the drafting is deliberate. A fixed date computed from the month of service is easier to administer across thousands of accounts than a rolling period from each date of service.

Subsection (b) governs direct billing to a plan issuer: by the date required under any contract with the issuer, or if there is no contract, the same first day of the 11th month.

Subsection (c) does the same for third party payors operating under federal or state law, including Medicare and Medicaid — the contractual or regulatory date, or the default where neither applies.

So a contract or regulation can shorten the deadline but the statute supplies the backstop.

Subsection (c-1) handles the personal injury case, and it is the practically important one. Where services relate to a personal injury claim for which the patient is represented by an attorney, the provider may satisfy subsection (a) by submitting the bill to the patient’s attorney — unless the patient directs otherwise.

That reflects how these accounts are handled: the bill waits on the settlement, and the attorney holds the file.

Subsection (d) fixes what "date of billing" means — the date the bill is mailed postage prepaid to the address shown in the provider’s records, or mailed or otherwise submitted to the issuer or payor as required. Mailing, not receipt, is the event.