If you’ve been in a car accident, you will quickly realize the complex nature of medical billing which accompanies it. While personal injury attorneys are focused on getting you as much money as possible for your injuries, it’s important to understand how medical billing works in a settlement.
Below, our colleagues at The Layton Law Firm discuss important information to know about medical bills in personal injury claims.
Your Personal Injury Settlement Statement
Before you agree to any personal injury settlement, your attorney should show you what is commonly referred to as a personal injury settlement statement. This statement will show you the full settlement amount, together with reductions for attorney fees, expenses, and medical bills.
When reviewing this document with your attorney, make sure it is clear whether the payments being made to the medical providers will bring the balance down to zero. If there will be a leftover balance, you need to know that before accepting the settlement. While there are times when a settlement will not cover all medical billing—such as when fault is disputed – the goal is not only to put money in your pocket but also to avoid post-settlement billing.
Health Insurance Liens in Personal Injury Settlements
It comes as a surprise to most accident victims that if your health insurance plan pays for some or all of your medical bills related to the accident, the health insurance plan is entitled to be reimbursed for their payments if a settlement is reached. Not every health insurance plan is entitled to reimbursement and there are often federal and/or state rules which can limit the amount that must be paid to them. It is your injury attorney’s job to review the plan documents for the health insurance plan to determine what their reimbursement rights are. Often, your attorney can successfully negotiate with the health insurance company as to their entitlement as well.
Pro Rata Payments To Providers
Some states have what is commonly called a pro rata rule, which can limit what you have to pay directly to providers like an emergency room facility, or an emergency room doctor. As a result, those statutes often dramatically reduce the amounts that need to come out of settlement for your bills. Often, depending upon whether the providers submitted your bills to health insurance or not, the pro rata payment will also constitute a ‘full and final’ payment requiring the provider to write off the remainder of the bill. This means you will have a zero balance even though you only paid a portion of the bill through your settlement.
Negotiated Billing
Regardless of pro rata rules or statutes entitling facilities, doctors and health insurance companies to payment, if your attorney can successfully negotiate your billing to a lower amount with each provider or with all providers, that negotiation will serve as a binding contract with the other party, once again dramatically lowering your medical billing and reimbursements being paid from settlement. Generally speaking, any billing which is lowered means fewer dollars going to the providers and insurance companies and more funds going to you, the injured party.
Consult With A Personal Injury Lawyer
While there are many other reasons to consider using a personal injury lawyer to handle your injury claim, the billing component of your claim is often reason enough. The last thing you want when settling an injury claim is to reach a binding agreement with the at fault party only to realize that you have much more medical billing on the claim. Injured parties who settle without an attorney often realize this long after they’ve already agreed to a binding settlement amount.