Medical Bills Raise Many Questions In Personal Injury Cases
When I write a legal article, I never know whether it will gain reader interest. Some of the legal topics I find most fascinating, gain little or no reader interest. I’m often surprised at the articles generating the most readership and commentary.
One topic that always generates questions and commentary — Medical bills in accident and injury cases! I understand why. Medical bills are confusing and difficult to read. Every medical provider uses a different billing format. The charges vary widely. Who would think different hospitals could charge hugely different amounts for the same over-the-counter pain pill? Yet, they do.
On top of the medical charges, add the issue of health insurance and payment. Who pays? Blue Cross. Medicare. Tricare. Medicaid. Some other health plan. How much do they pay? Face it, each health plan pays differently. Most patients are confused by their medical bills when there is NO issue of any accident claim or lawsuit. I get it.
Medical billing is NOT just confusing to the patient. Some smaller doctor offices and independent pharmacies are also confused (or misled). I once represented an independent pharmacy in northern Alabama suing a large pharmacy benefit manager (PBM) for discriminatory drug payments. Pharmacy payments should be simple. You should be able to go to any pharmacy, get your heart medication, and your PBM pays (the same). Wrong! I questioned the key PBM executives who determined payment formulas. When the executives have no set formulas or different structures for different pharmacies, the medical system has huge problems that translate to more costs for consumers.
Now, let’s add an accident claim to the scenario. You suffered an accident, are injured and have a claim against an at-fault driver. You are seeking damages for your injuries. Medical treatment and costs are part of your damages. A huge part. Those complicated medical bills — They are now an issue. What’s more, how they are paid is now an issue.
Unfortunately, we live in a world of billboard lawyers operating settlement mills. These billboard lawyers promise quick checks for wrecks. They promise they will help. Who do they really help? They push cases to a quick resolution. That’s OK if your problems healed immediately and you have no long-term issues. What about people with serious injuries? What about long-term injuries that cause significant medical care, lost wages, or disability. If you suffered a serious injury, these settlement mill lawyers undervalued your claim. They settled too soon and too low. The end result of these billboard vultures is usually twofold: (1) You settle for too little; and, (2) You reimburse medical providers too much. Billboard lawyers usually do NOT negotiate reimbursement issues for you. Their lack of effort can cost injured people tremendously. These billboard lawyers continue to function because the billing system is confusing and many consumers do not know they received too little from their case. Many of these billboard lawyers are pretty good at smiling, sounding confident (over-confident) and speaking in comforting catch-phrases.
When I write articles discussing medical bills, medical payments, and medical liens, they often generate serious discussion. My recent article on efforts to amend Alabama’s hospital lien statute sure did. It even generated questions on our firm Facebook page. I understand why.
If you have questions about medical bills, let us know. We are happy to answer questions. Here are two of my past articles discussing medical bill issues in Alabama personal injury cases: