After you have been in a car or truck crash, you may have been rushed by ambulance to an emergency room. Expensive medical treatment and tests were performed. Worrying about how these medical bills were going to be paid was probably the last thing on your mind. So you will be shocked to find out later that you owe a huge sum of money for your medical bills. This happens often.
Berenson Injury Law has been representing injured Texans for the past 40 years and this can be one of the biggest hassles of the car/truck crash process.
We see one or more of these happening:
If this sounds familiar, that is because you were not told any of this at the hospital or by your doctors. You may not find out until months later when you open your mail and see “surprise bills” which can be $10,000 or more. You naturally assumed that the other driver’s insurance company or your health insurance plan would have paid these by now.
The medical bills morass is unfortunately a common problem after a car wreck, especially here in Texas. A recent study showed that we had almost the highest number of these out-of-network charges in the U.S.
If you have health insurance, you probably do not know which hospitals and doctors (other than your PCP) are in-network. You will have no idea what medical procedures cost. Before this happens to you, you should study your plan’s directory and research costs so you will be prepared.
What can you do to reduce your medical bills?
Tips for how to deal with surprise bills:
New law is a start towards patient protection
Senate Bill 1264 was passed during the last legislative session. It took effect on September 1st and affects medical services provided after January 1st. The law only affects Texans who are covered by state-regulated health plans (government employees and teachers).
There are new limits placed on medical providers who are out-of-network and try to balance bill. For the first time, these providers cannot bill for money in an amount more than the applicable copay or deductible. This amount will be based on the first amount determined that was owed or modified after an appeal (see below).
However, if the non-emergency medical service gave the patient certain notice, it is exempted from this cap. We are monitoring this notice to see if it is given to our clients who qualify.
The new law also requires that a dispute resolution process be set up when the health plan and medical provider disagree on the amount of the payment. They must have a teleconference within 30 days and must attend mediation or arbitration if necessary.
Analysis of new law
There are severe problems and shortcomings. First and foremost, it does not apply to most people who have self-funded employer-sponsored health plans or Medicare. This law needs to be expanded to all Texans.
Second, the patients can waive the balance billing protections when they have a choice between using an out-of-network or in-network provider, unless there is an emergency or the out-of-network doctor is assigned to the patient’s care later, e.g. a radiologist or anesthesiologist is added to the surgery.
Third, the out-of-network provider can claim it gave the patient notice the required 10 days in advance of the day of service if the provider intends to bill the consumer rather than request mediation or arbitration.
Non-emergency providers are required to give patients written notice in advance of certain important facts including the amount for which the patient may be responsible
The law survived a last-minute lobbying effort by the powerful Texas Medical Association which wanted to water it down even further.
12 Ways to get your medical bills paid
Our team is here to help you through every step of what can be an arduous journey, especially when it comes time to getting your bills paid.
One and probably more of these 12 options will be available:
Each method has its pros and cons. And it is important which ones are used and in which order. The resolution of this important topic will greatly affect how much money you end up receiving at the conclusion of your case.
A good car accident lawyer can explain how you should proceed.
Please call or email our office if you have any questions. We are here to fight to get you the compensation you deserve.
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