Medical Billing Myths & Misconceptions

 Medical Bills are Recoverable

If you have been injured in an auto accident, the at-fault driver will pay for your medical bills, but (much like our discussion on rental cars) it just might not be at each appointment.

Medical bills start rolling in after the car crash.

One evening you and your family are driving home on Fairview Road in Simpsonville, SC after dinner at Stella’s Southern Bistro when a car turns left in front of your vehicle, and with no other choice, you slam into the front right headlight of the oncoming vehicle. When the paramedics arrive, they take you and your family to Hillcrest Hospital, and they run many tests on everyone. Luckily, no one is seriously injured, but everyone is extremely banged up and rattled by the event.

About the time the family starts to recover from their injuries, the medical bills inevitably begin turning up. First, the EMS bill arrives, and you cannot believe how much that short ride cost. Then a few days later, the hospital bill arrives, and once you have come to terms with that total bill, a bill from the ER physician arrives.

This nonstop barrage of bills from the EMS, hospital, physician, radiologist, and pharmacist begin to pile up on your kitchen counter. When this continues, and the bill collectors start calling, it is completely overwhelming. That feeling effects everyone involved, and you are left to wonder, “Who is going to pay for these medical bills after a car accident?”

Many people believe that the at-fault party’s insurance will pay for their ongoing treatment. The insurance adjuster compounds the confusion when they tell you, “Don’t worry about a thing. Just submit your medical bills to me, and I will take care of it.” However, to the dismay of many people, the at-fault driver and his insurer have no legal obligation to pay for your medical bills after an accident on an ongoing basis. If the other driver is negligent, they are only obligated to pay you at the end of the case.

Who pays the medical bills after the car accident?

There is a common misconception that the at-fault driver’s insurance company or your attorney will pay your medical bills after an auto accident until a settlement or jury award comes in. This belief is not true.

Your attorney will request and gather all of your medical records and bills as the case proceeds so that they can correctly evaluate the damages in your case, but the medical bills are not actually getting paid.

The most important thing to remember is that you are responsible (for the most part) for the payment of your medical bills as you incur them along the way.

Although the property damage repair to your car is usually resolved fairly quickly, the medical bills are a different animal.

The at-fault driver’s insurer may offer you money early in the process, but you should always reject this offer. If you take it and your injuries have not resolved, you will release the driver and the insurance company from all of their legal obligations to you. An early settlement translates into absolving them of their responsibility to pay for ongoing and future care. And, in the event a medical issue related to the auto accident is discovered by a doctor in the future, you will have no recourse against the driver that caused the crash.

If you already accepted the quick payout, the new medical bills are your responsibility, and the at-fault driver would have no duty to reimburse you for those bills. Instead, you should seek immediate and complete medical treatment before you accept any money from the driver’s insurance company that caused the car wreck.

When will my medical bills get paid?

Most of your bills that are not covered by PIP or some other form of insurance will be paid at the end of your case either through settlement or a jury award, and your lawyer will negotiate the payment to those providers. No matter what you may have heard, this process may take several months to several years depending on the complexities of your injuries and whether or not there is a trial or a dispute regarding the liability in your case.

This process should not be surprising. The first reason is that a personal injury case involves a lot of moving parts and bureaucracies, i.e., billing departments, medical records companies, and multiple insurance companies. The second reason is that the settlement process will not start until your doctors release you from treatment.

Once released, your attorney will gather all of your medical records and billing, and then send those documents to the insurance company in a demand or settlement package to review. This process makes sure that all of your medical care is considered by the at-fault driver’s insurance company (as we mentioned above).

What should I do about my medical bills?

Every time you receive a medical bill, you should send that bill to your lawyer’s office. Even though your attorney is keeping track of these bills separately, it will help their office to review the statements you receive also. This process will ensure that nothing is missed at the conclusion of your case.

You should also make your attorney aware of every upcoming appointment and most importantly when you see a new provider. If you do not share that information with your lawyer, they will not know to request the records and billing for the new physicians that treat you.

Then at the conclusion of your case, your attorney will request a final statement from all of your healthcare providers, and they will negotiate the payment for the outstanding balances and subrogation interests.

But just because you have the prospect of an injury settlement, you still need to keep paying your bills as they come in. Do not allow the medical bills to pile up on your kitchen counter. You must take action on these bills. As we stated earlier, these bills are not going to be paid by the at-fault driver’s insurer (or your attorney) on an ongoing basis. These bills are often turned over to collections, and some of the healthcare providers can garnish your tax returns.

If you cannot pay the medical bills as they come in, you should contact the healthcare providers immediately and let them know the situation. You should make them completely aware of the reasons for treatment, and ask the billing company to hold off on sending the balance to collections until the case settles and you can pay. In most cases, the billing departments will accept small payments along the way to keep the balance out of the collections. You should also seek the assistance of your attorney to delay the collection process and keep those bills from hurting your credit score.

As we stated earlier, the most important thing to remember is that your medical bills are your responsibility. Even though someone else may ultimately be accountable for your injuries, the duty to monitor and pay them along the way is yours and yours alone.

Practical Advice

  • Check to see if the car you were a passenger in or driving carries Medpay or Personal Injury Protection (“PIP”) Coverage. Medpay and PIP Coverage cover your medical bills up to the limits of the policy. The only thing you need to do is to submit the invoices to the insurance company.
  • Whether or not you think you have “Full Coverage,” you should review your car insurance to see if you have Medpay or PIP Coverage.
  • If you weren’t a passenger in or driving your car, check to see if your automobile policy carries Medpay or PIP Coverage. If so, you can stack that coverage with the other Medpay or PIP Coverage. Also, it is important to note that using your Medpay or PIP Coverage will not increase your monthly premium.
  • You also need to make sure that your healthcare providers submit your bills to your health insurance company, including Medicare or Medicaid. Although you may have to pay your health insurance company back with the proceeds of your settlement, this will substantially lower the amount you are required to pay for your ongoing care.
  • Pay your medical bills as they come in, or call your healthcare provider and seek an alternative payment schedule for your bills while you wait for your case to resolve.

Contact an Auto Accident Lawyer

We believe that our job as a South Carolina car accident lawyer is to provide information and resources to our community about auto accident cases, but if a person needs specific legal advice and wants to hire a personal injury attorney, we are here to represent you and advocate on your behalf. Should you have specific questions about your car crash case, do not hesitate to book a consultation, send us a message, or call us at (864) 757-0757. We are here to help 24 hours a day.