Short Answer

In North Carolina, a healthcare provider will typically release a deceased patient’s billing or account information to the estate’s duly appointed personal representative (executor or administrator) upon receiving (1) certified Letters Testamentary or Letters of Administration and (2) a HIPAA-compliant authorization signed by that personal representative. A health care power of attorney generally ends at death, so it is not enough. For certain sensitive records, the provider may also require a court order.

Understanding the Problem

In North Carolina, how do I get a healthcare provider to release a decedent’s billing statements, and what authorization must I provide? Here, the provider asked for proof that an executor has been appointed plus a signed authorization. Prior counsel started the request but did not file anything. You want to know exactly what to send so the provider will release the account details.

Apply the Law

Under North Carolina law, the personal representative (PR) manages the estate and uses official “Letters” issued by the Clerk of Superior Court to prove authority to third parties. Providers also follow federal privacy rules for protected health information; after death, they generally require a HIPAA-compliant authorization signed by the PR. The main “forum” is the provider’s health information management or billing department. There is no fixed estate-law deadline to request records, but providers have retention policies, so act promptly.

Key Requirements

• Personal Representative status: Certified Letters Testamentary (will) or Letters of Administration (no will) from the Clerk of Superior Court to prove authority.
• HIPAA-compliant authorization: Signed by the PR, typically using the provider’s form, identifying the decedent, the records requested (e.g., billing statements), the recipient, purpose, expiration, and signature/date.
• Scope of records: Billing and account records are protected health information; providers apply the same authorization standards as for medical records.
• Sensitive categories: Certain records (e.g., mental health, substance use, psychotherapy notes) may require added specificity or a court order.
• Form and format: Providers often require certified copies of Letters and may reject general releases or authorizations not signed by the PR.

What the Statutes Say

• North Carolina Gen. Stat. § 28A-13-3 (Powers of personal representative) – Confirms the PR’s authority to take control of the decedent’s property and act on the estate’s behalf.
• North Carolina Gen. Stat. § 28A-6-1 (Application for letters; evidence of death) – Sets how Letters are issued, which the PR uses to prove authority to third parties.
• North Carolina Gen. Stat. § 7A-103 (Powers of clerks of superior court) – Clerk powers include issuing subpoenas and orders in matters before the clerk, which can aid record access if disputes arise.

Analysis

Apply the Rule to the Facts: Because no documents were filed by prior counsel, the provider lacks proof of a duly appointed PR. First, the estate’s attorney should obtain certified Letters from the Clerk of Superior Court; those Letters establish the PR’s authority to act. Next, the PR should sign a HIPAA-compliant authorization (often the provider’s own form) specifically permitting release of the decedent’s billing statements to the requesting attorney. With both items faxed to the provider’s records/billing department, the provider can release the account information.

Process & Timing

1. Who files: The personal representative or the estate’s attorney. Where: The provider’s Health Information Management/Medical Records or Billing Records department in North Carolina. What: Certified Letters Testamentary or Letters of Administration, plus a HIPAA-compliant authorization signed by the PR (preferably on the provider’s form). When: As soon as Letters are issued; providers may process within days, but timing varies.
2. If no PR is appointed yet: Who files: The nominated executor (if a will) or an eligible heir/creditor applies with the Clerk of Superior Court. Where: Clerk of Superior Court in the county of the decedent’s domicile. What: The Administrative Office of the Courts forms for probate and letters (e.g., Application for Probate and Letters or Application for Letters of Administration), death evidence, and any required bond. When: Appointment time varies by county; many issue Letters within a short period once filings are complete.
3. Final step: Send the provider the certified Letters and the PR-signed authorization. Expect release of account-level records such as billing statements or account ledgers consistent with the scope of the authorization.

Exceptions & Pitfalls

• Health care power of attorney ends at death: A health care agent’s authority generally terminates at death and will not satisfy a provider’s release requirements.
• Provider-specific forms: Many providers require their own HIPAA authorization form; generic releases are often rejected.
• Sensitive records: Mental health, substance use, HIV, or psychotherapy notes may need added specificity or a court order; expect narrower releases.
• Affidavits vs. Letters: Some holders refuse to act on small-estate affidavits and will insist on Letters; opening a formal estate may be more efficient than forcing compliance.
• Stale or uncertified Letters: Send recent certified copies; some providers will not accept photocopies or older certifications.
• Litigation route: If a provider refuses despite proper documentation, a subpoena in a pending case or an order entered in an appropriate proceeding may be needed.

Talk to a Probate Attorney

If you’re dealing with getting a healthcare provider to release a decedent’s billing records, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at [919-341-7055].

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.