I Need to See a Doctor for my Back Injury. How Am I Going to Pay the Medical Bills?
Nov. 5, 2020
Under Oklahoma statute, a doctor providing treatment to someone injured in a motor vehicle collision is authorized to file a lien, for the amount of the medical bill, against the at-fault driver and his/her liability insurance company (i.e., Liability Carrier).
Many people, who purchase health insurance, whether an HMO or a PPO, often do not want their treating doctor to bill their insurance because the person responsible for causing the collision and injury should pay the medical bills. Indeed, why should the person responsible for causing the injury get the benefit of injured person’s health insurance?
Oklahoma statutes guarantee that injured Oklahomans have access to treatment for their injuries -- without having to pay out of pocket or having to submit the bills to their health insurance. Likewise, these statutes are designed to make sure the doctor’s bill will be paid by the at-fault driver’s insurance company (i.e., Liability Carrier).
Because the at-fault driver’s liability insurance company will be responsible to pay the damages caused by the at-fault driver, these claims are often referred to as “third-party claims.”
If your doctor will not see you because you were involved in a motor vehicle collision (i.e., on a third-party claim basis), call the Rode Law Firm at (918) 599-8880 to get started on your Road to Recovery. At the Rode Law Firm, we help our clients:
First, to recover their property damages;
Second, to recover physically from their injuries with proper medical treatment and care; and
Third, to recover financially from the responsible party/insurance company.
Oddly, many doctors accept patients with HMO’s and PPO’s and agree to accept .35 cents to .60 cents on a dollar from the Health Insurer. However, if these same doctors were to file a lien, in most cases, the doctor predictably would receive closer to .80 cents to a dollar for each dollar billed, and potentially receive the full amount billed for their services. The disadvantage is that the doctor may have to wait longer for the case to be settled to receive payment, especially in cases where litigation is necessary. Regardless, the doctor’s primary goal is to provide the best treatment and care to the patient, and payment should be secondary.
And, on this secondary consideration, it should be noted that payment of the bill, other than the patient’s health insurance, can come from (1) payment from settlement from the Liability Carrier, (2) payment from settlement with the UM Carrier, and/or (3) payment from the Med Pay Carrier. That is, there are potentially 3 sources from which to pay the medical bills (i.e., not including health insurance) from which a doctor can receive a larger payment for his/her services then the traditional drastic reduction required under a health insurance contract.
Unfortunately, there are still some doctors/clinics who refuse to treat people injured in motor vehicle collisions (i.e., on a third-party claim basis) because they don’t know (1) about the lien statutes; (2) they do not understand that there are potentially 3 sources of automobile coverage to pay their patient’s bill; or (3) they do not know how to process the lien paperwork, which is much less complicated and time consuming than processing HICFA Insurance forms required by an HMO or PPO. That is not to say that you will be refused emergency medical treatment. The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law that requires emergency rooms to treat and stabilize anyone regardless of ability to pay.
If your doctor is willing to see you and treat your injuries, but only on a health insurance basis, be aware that the Health insurer will have the right to subrogate and collect the amount it pays from the liability settlement. In rare cases, this can be in the client’s best interest to allow the doctor to bill their health insurance. Some typical examples of when this could be beneficial are when there is a major question as to who is at fault in the collision, when the patient had a pre-existing condition, such that it will be difficult to differentiate, whether the treatment is the result of a new injury caused by the collision, whether the treatment is a result of an on-going pre-existing condition (or aggravation of a pre-existing condition or old injury), or when there may be an insurance coverage or limitations issue such as when there are multiple severe injuries by several people on the same policy. Such factors can force a compromised settlement that may not cover all the medical bills, and in such cases, it is often advisable to allow the doctor to bill the Health Insurance Carrier.
In representing our clients, we discuss this dichotomy of these complex issues as they arise and advise the client what is in their best interest, both physically and financially.
If your doctor will not see you because you were involved in a motor vehicle collision (i.e., on a third-party claim basis), and you need treatment to recover from your injuries, call the Rode Law Firm at (918) 599-8880 and get on your Road to Recovery. We will help you get the treatment you need to fully recover from your injuries, and we will help you recover the compensation you deserve.