Paying Your Medical Bills©
Once you’ve identified your medical bills so they can be paid; it’s time to begin the payment process. (Read this article after my previous article called “Negotiating Medical Bills Made Easy”.)
Paying your medical bills can cause anxiety for many injury victims. So, the following is a suggested outline. Every case is different, so consider this a brief overview only, in my humble attempt to give you some control during this healing and litigation process.
Private Health Insurance
Ordinarily your private health care insurance company (i.e. HMO, PPO) will pay the bills. The key is to give your medical providers (i.e. ER, Hospital, Surgeon etc.) your health care policy number, name and contact phone number. Empower and prompt your treating medical providers by giving them your health insurance data and by your follow up calls/e-mails to get these bills paid. Why prompt them? Because you want your medical bills paid before your medical healthcare insurance company discovers you have a personal injury case. Some Health Insurance companies will play hardball and deny paying your bills until you give them extensive information about your personal injury case, so they can attach a lien for all their costs (even if they are only entitled to a capitated lesser amount per contract). In other words, some, attempt to hold your medical care and payments “hostage”.
So, get your medical providers to bill your health insurance company asap, because the health insurance companies will turn your account over to their collections agency arm (i.e. Blue Cross uses a company called Merridian to collect their bills).
The benefit of promptly getting your bills paid is that your medical providers will likely continue treatment and won’t bother you. Then, it’s easier for me to later negotiate a reduction of repayment from the health insurance company, as your medical treatment was complete. In other words, you received care and your treatment providers were paid.
Use your Auto Medical Pay Provisions to Pay Residential Bills
Say your health insurance (HMO, PPO) plan only pays 80% and you pay 20%. The dilemma is paying the 20% balance. The next logical step (once your health insurance payments per health provider is maximized), is to again empower your health care providers to bill your automobile medical payment insurance. That’s right; your own auto medical pay coverage will often kick in when other health insurance is exhausted. That’s how the auto med payment provisions are often worded. (Note: if you don’t have health insurance, then your auto med pay may be your first and only payment option). Yes, your own auto medical payments will pay even if you’re in a bicycle accident; they may want repayment or credit against any under/uninsured motorist claim if the bad guys (who caused the crash) failed to have enough insurance. But, leave that legal issue to me. (See Insurance Code section 11580.2 et. seq.) Again, empower your medical providers to promptly bill your auto med pay. Most auto policies have $5,000.00 in med pay coverage, some more.
Uninsured Victims: Using a Lien to Relieve Pressure
Some of my clients are flat out uninsured. That’s right, they have no private health insurance, or auto med pay. (i.e. veterans with Champus or VA benefits, or retirees with Medicare). Assuming you’re not a vet or age 62 years old, then you might ask the medical providers to take a lien (a charge) against your personal injury recovery. By signing an agreement to pay at the end of your case, you have given your medical providers some assurance you’ll pay them. Of course, liens can often be negotiated later on, depending on the final settlement amount. But, while your legal case is processing – the doctors might just leave you alone and forego surrendering your account to collections.
Medical – Legal Litigation Companies will Finance Surgery
Should you need surgery, there are medical – litigation companies that will advance medical treatment if you sign a lien. Basically, these medical litigation companies will act as middlemen and connect you with medical providers for a fee. These companies earn their profit by obtaining reduced prices from hospitals and surgeons, all the while absorbing the risk by guaranteeing the hospital and doctors payment upon settlement. With the rising number of uninsured clients (due to sky rocking premiums and employers unable to provide medical insurance), this option is very popular.
Ask to Make Low Monthly Payments
A fourth option to pay medical bills is to ask the medical providers to accept low monthly payments (or a combination of low payments and a lien against your case), as long as they hold off sending your case to a collection agency. Most doctors will be willing to work with you, while you’re getting back on your feet. Offer them post dated checks that fit your budget.
Litigation Loans Will Fund Your Case
A great alternative, for many people, is to obtain legal case funding. There are companies who will advance you litigation funds (i.e. for loan costs of living and litigation costs, and to pay down your medical bills). These litigation loans are often “non-recourse” loans, which means you don’t have to repay them if you lose your case. I have had several clients who used this option with success, even though their interest rates and fees can be high. Having the financial strength to litigate often means the case value increases.
Poverty Level Victims May Be Forgiven
In case you’re rated at the “poverty level” (about $28,000 per year), some hospitals will deem you a hardship case and forgive any debts you owe them in order for them to continue to receive Federal/State funding or benefits. That’s the trade off. They need to give up some services to be eligible to collect on other accounts from the government. Some hospitals have a heart.
Medi-Cal and Medicare Strategies
Then there’s Medi-Cal and Medicare. These agencies have unique rules, and can be slow to tell you what you really owe. So, stay on them, and frequently ask for updates. Note: I believe it’s Medi-Cal that pays a substantially reduced rate to health care providers. Once the healthcare providers accept payment from Medi-Cal, they (by law) cannot bill you the original higher bill. So, make sure Medi-cal promptly pays, and then you’re off the hook for a lot. Warning, if the hospital learns you have an injury case; it may delay submitting bills to Medi-Cal and attempt to recover more against your legal case. As for Medicare, new rules are evolving, whereby they want assurances you won’t need future care when you get older. If you do, they may require a separate account set up when you settle your case.
Veterans & Military Dependents
Military Veterans often receive care through the VA Hospital or are covered by Champus – their administrator.
In sum, keep track of all your bills, credits and payments by frequently calling your treating health care providers. At the same time, compare your HMO, PPO, explanation of benefits (EOBS) to track what bills are getting paid. Once you determine what’s left and owing, then go into action as described above, if the medical providers want payment. However, this won’t happen until about 90-120 days after a crash. At no time should you disclose that you have a personal injury case – until you have consulted with me. However, do disclose your private health insurance to your treating medical providers.
Take action and don’t worry, because while all the above is happening I will be working towards obtaining a settlement for you. Please visit me often and we’ll work through your case.
I hope this helps!
©Richard L. Duquette, Esq. All rights reserved 2017 – LEGAL ADVERTISING
www.911law.com * 760-390-5234 * Podcast: Bicycling and The Law 911law.com
The information in this article is for general information purposes only. The focus of this article is on California Law. You should contact an attorney in your state for case specific advice, as details of the law and procedural requirements vary from state to state. Nothing in this article should be taken as legal advice for any individual case or situation. This information is not intended to create an attorney-client relationship; and the receipt, reading, listening, or viewing of this content shall not constitute an attorney-client relationship. Nothing in this article shall be construed as a warrant, promise, or guarantee about the outcome of your case or any other matter. This information may contain personal impressions or statements of opinion on a subject that do not apply in your case. Further, statements of law reflect the current state of the law at the time of writing and/or recording, and may not reflect subsequent changes in the law.