Patient Rights

North Dakota Patient Billing Rights

Know your rights as a patient in North Dakota. From surprise billing protections to financial assistance programs, here's what the law says about your medical bills.

Hospital Data Surprise Billing Financial Assistance Medical Debt FAQ File a Complaint
Real Data

North Dakota Hospital Pricing at a Glance

Based on CMS cost report data from 23 hospitals in North Dakota.

23
Hospitals Tracked
1.9×
Avg Charge-to-Cost Ratio
$88,000
Avg Charge per Stay
72,000
Annual Discharges

North Dakota hospitals charge an average of 1.9× their actual costs. The average hospital stay is billed at $88,000, while the actual cost is $46,300. Compare prices at specific hospitals →

Federal No Surprises Act (2022) — Applies in North Dakota

The federal No Surprises Act protects all North Dakota patients, regardless of state laws:

  • No surprise bills for emergency services at any hospital, in-network or out-of-network.
  • No balance billing from out-of-network providers at in-network facilities (anesthesiologists, radiologists, etc.).
  • No surprise bills for air ambulance services from out-of-network providers.
  • Good faith estimates for uninsured/self-pay patients — dispute if the bill exceeds the estimate by $400+.
  • Applies to all insurance types including self-funded employer plans not covered by state law.
State Protection

Surprise Billing Protections

Limited State Protections — North Dakota does not have comprehensive state surprise billing protections. Patients rely primarily on the federal No Surprises Act.

  • North Dakota lacks a comprehensive state surprise billing law — federal protections are primary.
  • The federal No Surprises Act protects against out-of-network emergency bills.
  • North Dakota law requires insurers to cover emergency services regardless of network status.
  • The North Dakota Insurance Department handles consumer complaints.
  • Self-funded employer plans are protected solely by the federal No Surprises Act.

What this means for you

If you receive a surprise out-of-network bill, you are not responsible for the balance beyond what you'd pay for in-network care. Contact your insurer and reference the Limited State Protections to dispute any balance bill.

Assistance

Financial Assistance & Charity Care

Under Federal 501(r) & North Dakota Medicaid Expansion, hospitals in North Dakota must provide financial assistance to qualifying patients.

  • Non-profit hospitals must maintain financial assistance policies under federal 501(r) requirements.
  • North Dakota expanded Medicaid, covering adults with incomes up to 138% FPL.
  • Many North Dakota hospitals are critical access hospitals with community assistance programs.
  • Hospitals must post financial assistance policies and provide applications to patients.
  • North Dakota's Medicaid provides comprehensive coverage including behavioral health services.

How to apply

  1. Ask the hospital's billing department for a financial assistance application.
  2. Gather proof of income (pay stubs, tax return, benefit letters).
  3. Submit the application — you can often do this even after receiving a bill.
  4. If denied, appeal the decision and contact your state insurance department.

Income threshold: Varies by hospital (Medicaid covers up to 138% FPL)

Debt Protections

Medical Debt Rights in North Dakota

North Dakota has a 6-year statute of limitations on written contracts. Medical debt falls under this limit. After 6 years, creditors cannot sue to collect.

6 years
Statute of Limitations

After 6 years, creditors cannot sue you to collect medical debt in North Dakota. The clock starts from the date of your last payment or acknowledgment of the debt.

Your Protections

  • North Dakota allows garnishment of up to 25% of disposable earnings for medical debt judgments.
  • North Dakota expanded Medicaid, covering adults with incomes up to 138% FPL.
  • Paid medical debt is removed from credit reports. Medical debt under $500 is excluded.
  • North Dakota's homestead exemption protects up to $150,000 in real estate equity from creditors.
  • North Dakota provides a generous homestead exemption and limits on collection practices.
Know Your Rights

Additional Patient Rights in North Dakota

Beyond surprise billing and financial assistance, federal and state law provide these important protections.

Good Faith Estimates

Uninsured or self-pay patients can request a good faith estimate of charges before receiving care. If the final bill exceeds the estimate by $400 or more, you can dispute it through the federal process.

Itemized Bills

You have the right to an itemized bill showing each charge. Review it carefully — billing errors are found in up to 80% of hospital bills according to industry estimates.

Price Transparency

Since 2021, all hospitals must publish their standard charges and negotiated rates online. Use Taven's price comparison tool to see how North Dakota hospitals compare.

Payment Plans

Hospitals must offer reasonable payment plans before pursuing collections. Ask about interest-free options and negotiate monthly payment amounts based on your income.

FAQ

Frequently Asked Questions

What is the statute of limitations for medical debt in North Dakota?

North Dakota has a 6-year statute of limitations on medical debt (N.D. Cent. Code § 28-01-16(1)). After 6 years, creditors cannot sue you to collect.

Does North Dakota have surprise billing protections?

North Dakota does not have a comprehensive state law. The federal No Surprises Act (2022) provides the primary protections.

Does North Dakota have Medicaid expansion?

Yes. North Dakota expanded Medicaid, covering adults with incomes up to 138% FPL.

Can my wages be garnished for medical debt in North Dakota?

Yes, after a court judgment. North Dakota allows garnishment of up to 25% of disposable earnings. Your home is protected up to $150,000.

Where do I file a complaint about a medical bill in North Dakota?

Contact the North Dakota Insurance Department at 701-328-2440 for insurance complaints. For billing fraud, contact the North Dakota Attorney General.

Take Action

How to File a Complaint in North Dakota

If a hospital or insurance company is violating your rights, you can file a formal complaint.

North Dakota Insurance Department

For insurance-related complaints: claim denials, balance billing, network issues.

📞 1-701-328-2440

File a complaint →

North Dakota Attorney General

For deceptive billing practices, fraud, or consumer protection violations.

File a complaint →
Compare Prices

Hospitals in North Dakota

Compare prices at 23 hospitals across North Dakota. Click any hospital to see their procedure prices and negotiated rates.

Browse all 23 North Dakota hospitals →

North Dakota Resources

ND Insurance Department North Dakota Medicaid ND Attorney General — Consumer Protection ND Dept. of Health & Human Services

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🔗 Helpful Resources

🔍 Free Bill Review Tool ⚔️ How to Fight a Hospital Bill 💬 Medical Bill Negotiation Guide ✉️ Appeal & Dispute Letters ❓ Why Is My Hospital Bill So High? ⚖️ All State Patient Rights