May 16, 2014

Since No-Fault benefits, also called personal injury protection (PIP) expired in 2003, there has been confusion (some real and some imaginary) about the coverage that medical providers can accept to provide medical care for people injured in auto collisions in Colorado. I hope this article clears up this confusion.

Many clinics seem to avoid billing health insurance so that their bills are not re-priced by health insurance companies (i.e. $30 charge for hospital syringes whereas health insurance would only pay $2 per syringe). Clinics and hospitals deal with health insurance restrictions and re-pricing on a daily basis. I suspect that when a hospital has a patient with injuries from a motor vehicle collision, some hospitals see this as an opportunity to bypass dealing with health insurance so the hospital can make more money by putting a lien on the settlement proceeds.

However, hospitals can't do this unless the patient signs paperwork allowing the direct payment of the hospital bills from the personal injury settlement. Some patients are even told that when they are injured in a car crash, Colorado law does not allow them to treat using their health insurance. This is not only an incorrect statement of the law, but in my view, a fraudulent misrepresentation of the law. I always warn potential and current clients to not be fooled by hospitals' false representations.

Did you know that doctors and therapists must accept your medical insurance? The fact is that if your medical provider accepts your insurance for other visits, they need to take your insurance for car crash related care. If they refuse, I believe it is in your best interest to go to a different medical provider who will accept your health insurance. Nevertheless, your health insurance company has the right to place a lien on your settlement for the amount that was paid for your care.

You might think that if your doctors or chiropractors prefer to get paid at the end of your personal injury case from your settlement, and since the money your health insurance pays for crash related care needs to be paid back anyway, what difference does it make? What's wrong with cutting out the middleman by signing the doctor's lien paperwork? The answer is nothing is wrong with signing a lien with the doctor if you are fine with receiving

As discussed earlier, your health insurance only pays a fraction of the gross price of your medical bills due to re-pricing. While you might have to pay your health insurance provider back some money under Colorado law, there are some recent laws that allow Plaintiffs to repay little to nothing to their health insurance. Certainly, even if health insurance has to be paid back, it is never for more than the re-priced amount that was paid for your care. Whereas, if you let the clinic have an interest in your settlement, the clinic will seek the full retail value of the care provided.

So, if you are looking to receive more and not less of your settlement proceeds, you should insist that your healthcare providers bill your health insurance. You should rarely sign lien documents for healthcare, if ever. If your doctor or clinic insists on a lien, you should find yourself a new doctor.

At Anderson Hemmat, we believe that it's not what you settle for, but what you get to keep from the settlement that matters the most. If you are injured in a car accident, treating with health insurance will maximize your recovery. Most providers will tell you that if you are injured in a car accident, you cannot use your health insurance to treat. They are wrong. Give us a call today so that our experienced personal injury attorneys can help ensure you get to keep more of your settlement or verdict. Click here to start your FREE personal injury case evaluation.


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