How to Check Your Deposits, Itemized Charges, and Final Invoice at Discharge

Before settling your hospital bill, ask the hospital for an itemized statement of charges and a settlement statement for this admission, then compare them with every deposit receipt. First check the total charges, then see which payments have been applied and how much you still need to pay or should receive as a refund. An insurance guarantee or an amount the hospital has accepted as due from a third party does not mean the insurer has paid. Even if the hospital says it has issued a refund, check that the money has reached the receiving account.

Key Points

• Check your name, inpatient number, hospital campus, charge start and end dates, and currency to avoid mixing records from different visits.
• A deposit is money paid in advance; the itemized statement lists charges; the settlement statement explains payments applied, additional payments, or refunds. The final medical fee receipt and the itemized statement serve different purposes.
• Apply each actual payment only once. Keep separate records of money the hospital has actually received, amounts it has accepted as due from a third party but has not yet received, and the amount it currently requires the patient to pay.
• For any charge you question, record the item, date, and amount, ask the hospital to explain it, and keep its response. A refund request or a hospital refund receipt does not mean the money has reached your account.

Documents to Prepare

Gather all deposit receipts, payment records, estimates, and package agreements from admission and during your stay. Ask the inpatient billing office for an itemized statement of charges through discharge and a settlement statement. If you have insurance preauthorization or a letter of guarantee, keep these with the other documents. Check the name, inpatient number, institution and campus, charge dates, and currency on each document. If the spelling of your name or the visit number differs, ask the hospital to confirm first that the documents relate to the same admission.

Deposit receipts show how much you paid, but do not show whether each service took place. Estimates depend on stated conditions and are not final bills. Public health insurance or commercial insurance may require additional settlement documents; prepare these according to your own coverage arrangements.

How to Check Itemized Charges

First check that the total on the itemized statement matches the charges for this admission on the settlement statement. Price management rules for public medical institutions require an itemized statement of charges, except for settlement by disease category or diagnosis-related group (DRG). The statement must include the names and codes of services, medicines, and medical supplies, unit prices, billing units, dates of use, quantities, and amounts. Ask the hospital to explain missing fields or differences in totals.[1]

Prioritize expensive, canceled, or unfamiliar items:

1. Compare names, dates, quantities, and units, and ask how charges are calculated for “one session,” “one day,” or “one box.” The same name appearing twice does not necessarily mean a duplicate charge.
2. Ask the ward to check what was actually provided against medical orders, medication administration records, and examination or procedure records. If medicines were returned or an examination was canceled, ask the billing office whether the reversal appears on the final bill.
3. If settlement is based on a package or disease category, ask whether the itemized charges are components of the package or additional charges, so you do not add included items again.
4. If a unit price differs from what you expected, ask the billing or price management department about the applicable item, scope of service, billing unit, and price at the time. Prices may differ by region, institution, and service type. Do not assume that an estimate or another hospital’s price is the applicable rate for this admission.

How to Calculate an Additional Payment or Refund

Under the 2025 notice on deposit management, public medical institutions should, in principle, complete inpatient bill settlement within 3 working days after discharge. Confirm the specific procedure and any special circumstances with the hospital. This settlement deadline is not a deadline for the refund to reach your account.[2]

Ask the billing office to list the charges due for this admission using the same inpatient account, currency, and settlement cutoff, and check them in three separate columns:

1. Money the hospital has actually received and applied to this settlement: This includes deposits, additional payments, and third-party payments the hospital has received. Check the date, amount, payer, payment channel, and hospital transaction number for each payment. For bank card preauthorizations and failed or reversed transactions, first confirm whether any money was credited. Apply each payment only once.
2. Amounts the hospital has accepted as due from a third party but has not yet received: Ask the hospital to record the amount, covered items, payer, and status. A letter of guarantee or preauthorization is not proof of receipt. Even if the hospital has included the amount due in the settlement, this does not mean the insurer has paid or that the patient’s responsibility has been finally resolved.
3. The amount the hospital currently requires the patient to pay: Ask the hospital to explain how it was calculated and whether you need to pay any amount upfront pending third-party payment. Under an agreement, the hospital may temporarily allow the patient not to pay an amount pending from a third party. Amounts due, payments received, and the patient’s current payment requirement must be kept distinct.

Obtain written confirmation from the hospital and insurer of the scope of the guarantee, expected amount, current status, and how any shortfall or refusal to pay by the third party would be handled and who would be responsible. Keep their responses, contact details, and the date for checking again. Responsibility depends on both parties’ responses, agreements, and applicable rules; do not assume in advance that the patient must bear it.

Fictional example, for accounting purposes only: The charges due for this admission are 10,000 yuan. The hospital has received and applied a patient deposit of 6,000 yuan and has also received a third-party payment of 2,000 yuan. If these are separate payments with no overlap, another 2,000 yuan is due. If the total paid on the settlement statement already includes the deposit, do not subtract it again.

If the same third-party amount of 2,000 yuan is still an unpaid amount due that the hospital has accepted on account, the hospital has actually received only 6,000 yuan, leaving 4,000 yuan in charges for which payment has not yet been received. Of this, 2,000 yuan is pending from the third party. Whether the patient must currently pay the other 2,000 yuan depends on the hospital’s bill and written confirmation. Even if the hospital currently asks the patient to pay only 2,000 yuan, the pending third-party amount of 2,000 yuan cannot be treated as received, and the full unreceived amount of 4,000 yuan cannot automatically be treated as the patient’s debt.

If a deposit balance remains, ask the hospital whether it should be refunded, to whom, through which channel, what documents are needed, and how to check progress and contact the responsible staff. Record the refund amount, application date, hospital transaction number, and person responsible. After the hospital initiates the refund, the recipient should check the actual amount and date credited to the receiving account. If the bank card is no longer valid, the payer is not the patient, or the person has left the country, ask the hospital and payment provider in advance how this will be handled. Do not assume every refund can go back through the original payment channel.

What to Do if You Find a Discrepancy

Write down the item number, date, and amount of each charge you question, along with the payment or care records you are comparing it with. Give this information to the billing office or the hospital’s published price inquiry service. If the question is whether a service was provided, ask the ward to help check. You could ask:

“What service and billing unit does this charge cover? Is it already included in the package? If it was canceled or returned, when will that appear on the bill? Please provide an itemized statement and a written response.”

Ask which department is handling the issue, who to contact or what case reference number to use, what documents are missing, and how to check again. If charges are corrected, request updated itemized and settlement statements. Ask how the original receipt will be handled and whether it will be reissued, and keep both old and new versions and any refund records. If the dispute remains unresolved, state which items you still question and read any confirmation document carefully before confirming it. If you need ongoing care, discuss this with your treatment team; do not stop treatment on your own.

What to Take Home Before Leaving

Keep the final itemized statement, settlement statement, medical fee receipt, and receipts for deposits and additional payments. If there is a refund or dispute, also keep refund records, case reference numbers, and contact details. For electronic receipts, ask the issuing institution how to obtain, download, and verify them, and save the original files. Different institutions may use different types of receipts.

If you plan to claim from an overseas insurer, first ask the insurer which documents, languages, and translations it requires. You may also need a discharge summary, diagnosis or treatment records, and proof of payment. Keep the Chinese originals and item codes, and save translations separately. If you will need to check your bill after leaving the country, confirm whether you will still be able to access your hospital account or use other contact channels.

Frequently Asked Questions

What if I have lost my deposit receipt?

Contact the inpatient billing office with your inpatient number, payment date and time, amount, and any available payment records. Ask how to look up the payment and obtain a replacement receipt, and whose identification is required. Requirements vary by hospital. Do not treat a payment screenshot as a payment record already verified by the hospital.

Is there a standard deposit amount for public hospitals?

There is no single amount that applies to all patients. The 2025 notice requires public medical institutions to set reasonable inpatient deposit amounts based on factors such as diagnosis, treatment method, and settlement type, and to publish amounts for common disease categories. Separate provisions for patients covered by public health insurance refer to the average personal out-of-pocket amount for the same disease category and coverage category. Ask your hospital about your settlement type and applicable deposit amount. Do not apply the rules for patients with public health insurance directly to all international patients.[2]

Why does the hospital still require payment when the insurer has already approved coverage?

Approval, a guarantee, and the hospital’s actual settlement are separate steps. Ask the insurer to explain the scope and limit of its approval and whether it has sent a guarantee to the hospital. Ask the hospital to confirm the amount actually received, the amount pending from a third party, and the amount it currently requires you to pay. Then ask both parties to explain in writing how any shortfall or refusal to pay would be handled and who would be responsible. If the plan changes, ask whether it needs to be confirmed again.

If the itemized statement looks duplicated, can I request a refund directly?

You can request a review, but first compare dates, billing units, quantities, body sites, and records of services provided. Ask the hospital to explain whether each line is charged separately or included in another item. Once an adjustment is confirmed as necessary, follow up on the correction and refund.

Can I get an English bill?

Ask the hospital whether it provides English documents or explanations, then ask your insurer whether it accepts them and whether a certified translation is required. Keep the original Chinese itemized statement, item codes, and official receipts.

Who should I contact if my refund has still not arrived?

First use the hospital’s refund receipt to check the amount, initiation status, payment channel, and transaction number with the billing office. Then ask the recipient or payment provider to trace it. Record both parties’ responses and how to check again. Confirm the processing time based on the hospital’s and payment channel’s actual circumstances.

What if I discover an error after leaving the hospital?

Contact the hospital billing office with your inpatient number, the items in question, and supporting records. Ask what documents are needed to request a review, correction, and refund remotely. After a correction, request updated documents, keep the old versions, and update your claim documents as required by your insurer.

Sources

1. National Health Commission: Rules on Internal Price Management at Medical Institutions (2020; see the original text for the scope of the itemized statement and price management requirements).
2. National Health Commission and Other Authorities: Notice on Standardizing Deposit Management at Public Medical Institutions (2025).
3. Ministry of Finance and Other Authorities: Notice on Fully Implementing the Reform of Electronic Medical Fee Receipt Management (2019; electronic medical fee receipts and itemized inpatient charges).

Information checked: November 6, 2026. Confirm specific prices, payment procedures, and refund procedures with the institution providing your care.