How a Personal Injury Attorney Can Help
Behind the scenes they are going through a pretty intensive process to be sure that the right people are paying your bills in the right order to prevent any of the bills from going to collections.
This is necessary because you only get a check from the at-fault party or their insurance company at the end of the case when it is closed. But you can’t resolve the case until you know what it is worth. And you can’t know what it worth until the victim is feeling better.
Sometimes that leaves an injured victim seeking treatment for what could be years before the case is resolved and a settlement is reached.
The question then becomes how does the victim pay those bills and survive during those couple of years when the bills are stacking up.
Medical care can be extremely expensive so this is a major concern.
How to Get Medical Bills Paid After a Car Accident
How Does it Work?
When you are hurt on the job the work comp insurance is actually the primary payor. It will be the first insurance to kick in and handle medical bills related to your injury.
So the workman’s comp insurance needs to be notified and you need to be issued a claim number. Then all of your bills can be sent directly to them.
These types of cases are fairly rare but nonetheless are a possibility that needs to be considered.
Typically, with most car accident cases, there is no work comp carrier but there is PIP or personal injury protection.
What is PIP Insurance?
PIP insurance is a coverage on your auto insurance policy. This coverage is required by law to be on every auto on the road. This insurance is the first coverage that is responsible for medical bills that are the result of an injury sustained in a car accident.
When someone is injured in a car accident the ambulance might take them to the emergency room for treatment.
There may be small, out of pocket expenses like pain meds that were prescribed by the emergency room doctors.
These charges would be paid by the PIP coverage of the owner of the vehicle that the injured person was in.
Even if that vehicle was not driven by the at-fault driver. These initial bill payments will be reimbursed later by the at-fault insurance company.
This enables everyone to seek needed medical attention without waiting to figure out who is at-fault and who will be responsible for the bills.
How Does it Work?
The PIP coverage works on a first come, first serve basis. Meaning that the first medical bills to be processed through the PIP will be the first ones to be paid.
Sometimes that may not be the first medical services that were rendered after the accident. One medical facility just may be faster at submitting the bills for payment.
If a patient went to the ER first after an accident but then received treatments from a chiropractor for two months after the accident.
If the chiropractic physician’s billing staff is faster at getting that bill turned in for payment than the hospital, then the chiro will be paid first.
This is important because once the PIP limit is reached, which is usually $3,000, then those funds are exhausted. At this point any further bills will be denied payment by the PIP coverage and will need to be paid by another source.
When this happens the insured will receive a log of PIP in exhaust. This log will show who was paid and in what order they were paid and the amount they received.
This will aide you in tracking where the money went and help you prove that the PIP money has run out when you are trying to get your medical bills paid after a car wreck.
After the PIP insurance has been exhausted then another means will need to cover the medical expenses. The victims health insurance will be next in line to pay the bills.
What is Medicaid?
Medicaid and Medicare are both government entities that provide health insurance benefits.
They are health insurance programs for low-income individuals or people with various disabilities that meet certain criteria in order to qualify for those medical benefits.
Medicaid is generally for people who need low-cost medical care and are unable to afford it and Medicare is for people over the age of 65, senior citizens.
How Does it Work?
Your attorney and his/her staff are required to put Utah medicare and Medicaid on notice of the fact that you have been injured as the result of the negligence of another.
That way Medicare and Medicaid can actually see your bills come in and not pay them. They won’t pay them until they see that the PIP has been exhausted.
The PIP needs to pay and run out first. Once that has run out your attorney’s office will need to track that fact and provide a PIP exhaust letter to Medicaid or Medicare and then begin informing debtors, the various medical providers, to bill Medicaid or Medicare next. They will then go ahead and process those bills and pay them.
So to reiterate if Medicaid or Medicare receives a bill and they are aware that it relates to an injury that resulted from an accident, they will deny it. They will do this until they receive a PIP exhaust notice.
How Does it Work?
They still need to be put on notice that some of the bills coming in will be related to an auto accident.
This is because when they pay the bills that are related to an auto accident caused by someone else, then later when they discover that the injuries were in fact due to a third party case, they may attempt to subrogate against your personal injury settlement.
What that means is they will pay those bills but they are going to want that money back.
So in the end, when you are in a car accident, health insurance really just serves as a short term stop gap that helps you get from point A, the accident, to point B, getting the money from the third party auto insurance carrier.
Some people might say, “Why does my health insurance even pay? They are just going to get their money back, that doesn’t even help me.” That’s actually not true.
They become a huge help to you in multiple ways:
#1. You don’t get sent to collections while you are seeing doctors and waiting for your settlement.
#2. Health insurance normally gets huge discounts, contractual write-offs.
If your emergency room bill is $1000.00, they will bill your insurance company this amount, but the health insurance might only pay $700.00.
Then what happens is when the health insurance goes to subrogate against your third party personal injury settlement, often times your attorney may be able to negotiate some type of reduction.
So let’s say your attorney is able to negotiate a reduction of roughly one third. That will take that $700 down to below $500.
Now even though you’re going to be getting $1000 as part of your personal injury settlement, you only owe your insurance a portion of that.
This is because the third party insurance carrier is not entitled to the same discounts that you get. They don’t get to pay less just because you were smart enough to have health insurance.
They have to pay the full amount as if you have no health insurance. The health insurance becomes a windfall to you.
So if the at-fault insurance company pays $1,000 and you end up having to pay back your insurance only $500, then you just netted a significant amount of money in your pocket that would not have been there but for the health insurance that you were smart enough to have in place at the time of the accident.
The next thing that comes into play is what’s called attorney liens.
Once you have gone through answering the questions, Is there work comp? Is there PIP? Is there Medicare or Medicaid? What about private health insurance?, then you look into attorney liens.
What Are Attorney Liens?
Attorney liens are what you do when you have nothing else that will pay.
When you are represented by an attorney often times medical providers feel ok and comfortable if the attorney will sign a document granting them a priority access to your injury settlement if and when the case resolves.
The ultimate responsibility to pay those medical bills still remains the obligation of the victim. However, the attorney lien allows the doctor to treat you but then not demand a partial payment at the visit and then the balance in thirty days which is typical in the medical field.
How Does it Work?
They charge you the amount and create your bill but they just record it and put it in your file. Then they wait.
They don’t bill you. They don’t send you to collections. They don’t create problems for you and they continue to provide you with medical care on a regular basis.
They continue to provide the care that you need because they feel confident that their bill will get paid in full because your attorney has provided a lien in their behalf. They will be paid at the same time that you receive your portion of the settlement.
This option enables people who maybe don’t have health insurance or they are seeking medical care such as chiropractic care or massage therapy that their health insurance does not cover to get the care that they need.
The attorney lien would also be helpful in the event that the victim’s health insurance deductible is very high and they don’t have the money to cover the bills out-of-pocket.
These attorney liens can be a huge deal in allowing you to get the medical care that you need. At the end of the day if you can’t get the medical care that you need, no matter how hurt you are, your case is worth very little.
The opinions and records of the medical doctors are what change the value of the case. So it is important to be able to access the right type of medical records in order to treat and document your injuries.
Out of Pocket
When to Pay Out of Pocket
This type of situation would be the only time that an attorney would ask the victim to pay out-of-pocket expenses as they go.
Obviously, no one wants to be sent to collections while you wait for a year for your case to settle. However, we try to track every dime spent by that victim and at the end of the case the victim is going to be reimbursed for all of those expenses.
It will all come back to you if the case goes well. Good luck getting your medical bills paid after your car wreck.
Those are the six ways or tricks to get your bills paid while awaiting your personal injury settlement.
Related Content: Personal Injury Car Accident Check List
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