“I was in an accident. I needed treatment. Now the hospital is hounding me. What do I do?”
The question comes from a person injured in a car crash; he’s called me because a situation he never dreamed would happen to him now confronts him and can’t be avoided.
The conversation starts all too often with that litany. Or something close to it. A financial representative at the local hospital is reaching out, following up on a bill for treatment provided in the emergency room. It may be a radiologist’s office, the physical therapist or, worse, a collection agent.
Many times, the voice on the other end of the phone is frantic. The person was in a collision. Or was injured through no fault of their own. He didn’t ask to spend that Sunday afternoon many months ago in the Emergency Department. Or miss a handful of afternoons from his job to travel to and work with a therapist. But, he did. And medical care is expensive. The bills have accumulated, growing into a mountain on the kitchen counter.
So, what should you do if you’re injured as the result of someone else’s actions and require medical care and treatment?
First, take a step back. Ask yourself, “What would I do if I hurt myself at home?” Or, said another way, “How would I handle my bills if I didn’t have an injury claim?”
If you have health insurance, use it. If you have health insurance, provide your insurer’s name to your health care provider. If you have health insurance, insist – NO, DEMAND – that the provider submit its claims through your health insurer.
The reason is simple: submission of your claims through your health insurer guarantees that the claims will be promptly processed and paid. You will be responsible for any co-pay or deductible required by your policy. But, in each and every case, that amount will always be less than what you would owe if the provider billed you for the entire balance.
Prompt submission of the charges to your insurer will also avoid the accumulation of the mountain of invoices on your kitchen counter and all of the stress and anxiety that comes with knowing that you owe money to providers for treatment you never wanted nor desired.
Second, immediately seek legal counsel if your providers refuse to submit your bills to your health insurers. In many cases, the provider has a contract with the insurer requiring the provider to submit its charges to the insurer for processing, payment and reduction from the amount billed. This is the case whether your health insurance is through a large, national insurer such as United Healthcare or Anthem, or a government-administered program like Medicare or Medicaid.
In all cases, your health insurer will have a deadline during which claims must be submitted. This deadline is mandatory. Claims must be submitted before the expiration of the deadline for the insurer to be obligated to process and pay the claim. So, remember, time is of the essence.
Third, never, ever, ever provide your motor vehicle insurance information to the provider. Large corporate providers, usually the financial officers of your local hospital, want this information so that they can directly submit their bills to your motor vehicle insurer. These providers are hoping that you have medical payment coverage.
Medical payment coverage is a type of insurance that reimburses you dollar for dollar for the cost of care you require following a collision. The coverage exists without regard to whether you were at fault. If you require treatment and you have medical payments coverage, you can use the coverage to take care of your responsibilities – the co-pay and deductibles you owe under your health insurance policy.
Your health care providers want this information because, if you provide it and they submit their bills to your motor vehicle insurer, that insurer will pay their charges to them dollar for dollar, meaning that the provider will recover more than what it otherwise would receive from your health insurer.
Finally, immediately seek legal counsel if you are uninsured because you do not have health insurance. You do have options, but those options are dependent upon your financial status, the situation leading to your injury, the type of harms and losses you suffered and the provider from which you seek treatment.
Matt Devoti is a partner with Casey & Devoti, a St. Louis-based personal injury law firm. He handles a wide variety of personal injury cases and specializes in car crashes caused by impaired or distracted drivers. Matt is also an authorized speaker for the EndDD.org (End Distracted Driving) Student Awareness Initiative.
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