I had several tests done in 2018 and paid for ever...

I had several tests done in 2018 and paid for everything up front (as requested). A receipt was issued but no itemized statement was ever sent. I requested an itemized bill which is necessary to submit to my FSA. I asked for it to be mailed but it never arrived. I asked for one to be faxed but it also didn't arrive. Methodist won't email it as it is not HIPAA compliant but this massive institution was unable to send an encrypted email (which is HIPAA compliant). Four telephone calls later and reassurances later, and we have reached the FSA submission deadline so I'm going to be out of pocket for 2018. It will be escalated to a supervision next week (because they don't work after 5PM, even though their billing center hours are 7AM-7PM). If you owe them money you can pay that 24 hours a day because they will definitely have sent you a payment demand!
Luckily I will not drive 30 miles to avail of any other services, nor will my own patients as I will not be referring them into the Methodist system when other excellent specialists are available.