Medical bill forms

 

Short answer is YOU, but then the at-fault driver’s insurance company will reimburse you.

 

If you are injured in a car accident that is not your fault, the other driver (usually through his insurance company) is responsible for your medical bills. However the other driver’s insurance won’t pay your doctors directly or reimburse you after every doctor visit. And a settlement with the other driver's insurance could take months, or even years, depending on how long your medical treatment takes. In the meantime, most doctors and hospitals want to get paid right away and if they don't, they could send you to collections.

That’s where YOUR insurance steps in. If you have health insurance, Medicare, or Medicaid, you should submit your doctor bills to them. If you have "Medical Payment" coverage (“Med Pay” for short) under your own car insurance policy, you can use it to reimburse you for any out-of-pocket costs AFTER health insurance has paid, such as health insurance deductibles or co-pays.

If you don't have health insurance, Med Pay coverage, or any other means to pay for necessary medical care after an auto accident injury, Gama Law Firm can get you the treatment you need with medical professionals who will agree to wait for your settlement to get paid. Gama Law Firm can also help keep those bills you've already received out of collections.

 

Getting the best deal requires strategy and coordination

 

Keep in mind that when you do settle with the other driver’s insurance company, you may need to use a portion of that settlement money to reimburse your health insurance, Medicare, or other people who have treated you and not been paid.

Depending on the reimbursement rate and right to be reimbursed, the amount of a settlement you put in your pocket can be significantly affected by which bills you pay first, which bills you submit to health insurance or Med Pay, and which bills can wait until settlement. This involves strategy and careful negotiations with providers and health insurance companies. With over 60 years of combined personal injury experience, this is something that the attorneys at Gama Law Firm do very well.

Example of how medical bills get taken care of in a typical personal injury case:

  1. John gets injured in accident caused by someone else.

  2. John’s medical care includes an ambulance trip, a hospital visit, several doctor visits, two months of physical therapy, and a spine injection by a pain management doctor to help manage the pain.

  3. John submits all of his bills to his health insurance company. The spine injection is the only service that is not covered by his health insurance, but John’s attorney gets that doctor to agree to wait for the settlement to get paid back.

  4. After six months of care, John is discharged by his doctors.

  5. John's attorney prepares a settlement package asking for compensation for the FULL amount of the medical bills (even if some were discounted by health insurance).

  6. After some negotiations between John’s attorney and the other driver’s insurance company, John finally agrees to a settlement. The settlement includes fair compensation for all medical bills (including health insurance co-pays and deductibles), John’s lost wages, pain, suffering, and inconvenience.

  7. John’s attorney notifies his health insurance company about the settlement, who requests reimbursement for what they paid only (usually only 20-30% of the original billed amount). After some negotiation, his insurance agrees to reduce their reimbursement request by an ADDITIONAL 20%.

  8. John’s attorney also negotiates with the pain management doctor who agrees to discount his bill by 30%.

  9. John keeps the rest (minus attorney fees and any case costs), including the large difference between what was recovered in the settlement (original amount of bills) and what ultimately had to be paid back to providers and health insurance (usually only a fraction of the original amount of bills).


STILL CONFUSED?? That's understandable! Just call Aurora based Gama Law Firm today and we'll answer all your questions - even if you don't hire us. We've been helping injured victims deal with medical bills for over 60 combined years and we want to help you.