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CAN THE HOSPITAL REFUSE TO BILL MY HEALTH INSURANCE AFTER AN AUTOMOBILE ACCIDENT?

Car crash on the back

If you have recently been involved in an automobile accident and were taken to the emergency room at your local hospital, BE AWARE.

Many hospitals in California are refusing to submit their bills to a patient’s health insurance carrier if the patient was injured in an automobile accident. By refusing to send the bill to insurance, they are bypassing the discounts given to insurance companies in order to get more money from people injured in automobile accidents.

Instead of charging the injured patient’s health insurance carrier, the hospital will place a lien on the patient’s accident settlement. Hospital lien laws were “meant to protect hospitals from the burden of caring for uninsured patients.” But today the practice of not billing insurance has become so lucrative that some hospitals actually hire outside debt collection companies to scour police records for recent accidents to pursue liens. Some hospitals actually ask patients to sign waivers stating they don’t want their health care plans billed for their hospital stay.

But, what if you don’t file a lawsuit to recover damages for your automobile accident? Well, hopefully you are in contact with their hospital’s billing department to let them know you will not be pursuing legal action and they should bill your carrier.

What if you file a lawsuit but you recover less than the hospital’s bill. Under this scenario, as well as the one above, if the time to bill your health insurance has expired (there is always a time limit to submitting the bill to the carrier), you will now be responsible for the entire amount of the bill or the amount that is not covered by any settlement.

This could be disastrous for you, and very costly. I would suggest that if you find out the hospital is not billing your insurance, do the following:

  1. If you receive a billing that doesn’t state “insurance pending” or some indication the bill has been submitted to insurance, move on to step 2.
  2. Call the hospital or doctor and ask them to bill your insurance company. Give them the information on your insurance card. If they refuse to submit the bill to the carrier, move to step 3.
  3. Fill out a Claim Form for your insurance company and submit it, along with a copy of the bill.

We are having this happen to our clients more often than not. Contact us if this happens to you. Our consultations are always free. We are here to help resolve your issues.