A Nova Scotia woman is raising concerns about billing practices at the Annapolis Valley Regional Hospital after she received a bill for a room she never asked for almost four years after she gave birth.

In 2009 Sarah Robinson gave birth to her daughter Josie, but it wasn't until January 2013 that she received a $220 bill for her two-night stay.

"I was shocked," she said.

There are only private and semi-private rooms in the maternity section so even patients who don't have coverage are placed in those rooms.

Robinson said the baby’s father signed a paper asking for a private room, but there were none available so she was given a semi-private not realizing there was a charge.

The signed paper states that if no private room is available, "a patient may receive semi-private accommodation at the semi-private rate."

But there's also another option.

Patients can request a ward room which, if space is available, can be set up elsewhere in the hospital. If there's no space, they will be put into private or semi-private accommodation at no charge.

Robinson said if Josie’s father hadn't requested a private room, she still would have been placed in a semi-private at no charge.

She said the policy needs to be fully explained, especially to families stressed out by impending child birth.

"When they go into the maternity ward and they’re going to have a baby I don't think they're told that if you sign this piece of paper and you don't get a private room you're going to get the same accommodation you’d have if you didn't sign it and you'll pay for it then," she said.

Semi-private rooms are also supposed to include a television, phone and a newspaper, but Robisnon said she didn't receive any of those perks.

The letter from the hospital says if the bill is unpaid it will be sent to collection.

Robinson said she has tried talking to hospital officials, but so far they maintain she must pay the bill.