OK, now I'm really confused. I never heard of anyone not on Medicaid, or a member of an HMO, who went to the hospital and didn't get an itemized billing statement. Are you saying that a representative of the hospital's business office just said to her at discharge, "You owe us $11000," without specifying in writing what she owes it for? She needs to get a properly itemized statement (which will run to many pages) before she writes any checks. And believe me, her insurance carrier will have an itemized statement before it processes any claims.
But much of the "itemization" is often in code or language unfamiliar to a non-professional. I did not understand at all what most of the "tems" were.
I'm sure I made them very PO'd, but if they haven't the time to write a paragraph explaining why I was charged $300 for this or #450 for that, then I haven't the time to bother writing them a check.