Yes, a bill must be issued to the patient in all cases, unless the patient declines.

The purpose of a bill serves to inform patients of the services they have consumed, and their corresponding unit costs or charges.

If a patient is able to tap on TPAs and ends up with zero out-of-pocket payment, the licensee should still issue a bill listing the services provided. If the patient declines the bill, a bill does not need to be issued.

If the bill cannot be issued immediately, it is acceptable for licensees to inform the patient of the delay and provide the bill at a later date as soon as possible.

If patients are able to access bill information via their personal TPA platforms (i.e., applications or online statements), licensees can inform patients about this and seek patients’ agreement that a physical bill does not need to be issued.