South Florida Injury Lawyer Blog
When you have been hurt in an accident, medical care may begin immediately, and you may be worried about how you will pay your medical bills before you have received a financial settlement. At Quackenbush Law, our team works quickly to assess the situation, review all documentation and statements, advocate with insurance companies, and negotiate on your behalf.
PIP first
The first medical insurance coverage that kicks in is PIP – Personal Injury Protection – which is required on all auto insurance policies in Florida. If you don’t have auto insurance, you can seek coverage from the insurance policy of a family member with whom you live or that of the vehicle you were riding in at the time of the accident, depending on your individual situation. Regardless of what insurance company is paying your medical bills, you must see an approved medical provider within 14 days of the injury to qualify for PIP coverage.
PIP covers up to 80% of all necessary and reasonable medical expenses up to $10,000 resulting from a covered injury, regardless of who caused the crash. If a person’s injuries cause the person a loss in wages, PIP can cover up to 60% of these lost wages, up to $10,000.
Medical providers have 35 days after medical services to bill PIP directly, but since PIP only covers up to 80% of your medical bills, you may be liable for part of your medical expenses. At our law office, we can confirm that the hospital or doctor has properly priced the medical services. While most medical providers are honest, it is not unusual for medical costs to be overcharged to PIP, health insurance, Medicare, or Medicaid, especially in the case of an accident, where a possible personal injury lawsuit could provide significant cash. It is our job to make sure that medical providers don’t try to take more than their share of your settlement by overbilling you.
Medical insurance next
After PIP coverage is exhausted, your own medical insurance, Medicare, or Medicaid will be responsible, depending on your coverage, and will be billed directly. Again, it’s important to confirm that the bills are accurate. Keeping track of your medical visits and the services you receive can help protect against erroneous charges. Medical bills are also sometimes negotiable. We may be able to help negotiate down the bills, so that they are within your means.
Balance billing is the practice of charging customers more than their insurance company is willing to pay. In Florida, balance billing of emergency services is illegal for individuals with PPO and HMO health plans. In an emergency, you don’t have the opportunity to shop around and make sure you have in-network medical providers. Balance billing is also illegal if the medical provider has a contract with your insurance company to charge only a certain amount for a service. They are not permitted to charge you the remainder of the fee that the insurance company has waived. They may only charge you for copayments, coinsurance, and deductibles that are established in your plan.
Unless you’re an expert in health insurance, this may all seem very complicated. And it is, which is why you need experts to review your plans and your medical bills to make sure that you are being charged fairly.
Paying from the settlement
You will need to keep track of all medical bills you have paid while you are waiting for your settlement. This information is used in calculating the compensation demands in your personal injury lawsuit. Depending on the severity of your injuries, however, medical costs can accumulate, and you may not be financially capable of paying bills, deductibles, and copays that are not covered by or exceed your health insurance.
In these cases, there are a few options. As mentioned previously, we can work to negotiate a repricing of the bills and possibly set up a payment plan. You may also work with a patient advocate at the hospital or utilize community services to provide you with some protection and guidance.
If you are unable to pay, medical providers or your health insurance could put a lien on your settlement, which is a requirement for you to pay them when the lawsuit is settled. You’ll need to work with your lawyer to have the lien removed when you pay them through the settlement.
A letter of protection is another option. This letter is a contract between the patient and doctor, written by your attorney, in which you promise to pay medical fees when your settlement is paid out. This will allow you to continue to receive treatment in the meantime. Nonetheless, you should make sure that the bills being generated are accurate and that the services rendered are necessary. At Quackenbush Law, we often engage the services of medical experts to evaluate the bills to determine if a medical provider is providing only necessary services and is charging a fair price.
How long before my settlement?
The answer to this question varies significantly, depending on the severity of your injuries, the type of accident, and the amount of evidence that needs to be collected to calculate an appropriate compensation demand and construct a rock-solid case to ensure you get what you deserve.
Most personal injury lawsuits can be negotiated within 6 months to a year. Though most insurance companies would rather settle a case, I will go to court if necessary to get fair compensation, and I have a track record of winning significant awards. Contact me today, 24/7, at (954) 448-7288 to schedule a free consultation to discuss your case.