Nov 6, 2009

An absolute rule of thumb for anyone who was not at fault for an automobile accident is to make sure you continue to actively treat with your health care provider until they find your progress to be at maximum therapeutic benefit. That being said, we meet people everyday who explain that they are without financial resources to start, much less continue, medical treatment. They do not have health insurance and they either never had, or exhausted, the small amount of MedPay they had.

Rather than lecturing you on the value of extended MedPay and health insurance, let me do what I do for my clients. I will attempt to address this problem and propose several possible solutions. In this article I will attempt to identify and rate alternatives for people without payer sources for their medical care following an automobile accident.

ALTERNATIVE #1 - Doctor Liens:
Some medical doctors will give you medical care and wait to be paid from an eventual trial verdict or settlement. They will do this because they are able to assert a lien on any settlement you receive and they basically know that if you get paid, they will too.

Advantages: This approach allows you to basically get medical care on credit with the doctor holding the note, so there are no out-of-pocket costs to you.

Disadvantage: The doctor's bill tends to be higher than what the bill would have been if you paid cash or had health insurance. Another disadvantage is that the doctor becomes more of an interested party in the outcome of your civil case. This means that when he writes in his medical records that you are injured, the insurance company and jury may question his motives due to the fact that he only gets paid if you recover money for your injuries.

Conclusion: Having the doctor wait to get paid until you win or settle is a very well-regarded way to resolve the issue of keeping patients actively treating, despite the drawbacks associated with the doctor potentially appearing to lose her objectivity. My overall grade for this alternative method of payer source: B+.

ALTERNATIVE #2 - Finance Company Working with Doctor Group:
There are at least 5 companies in the metro area that provide patient financing. Basically, these groups will take your case and provide you a variety of medical physicians and therapy. They make their money by purchasing the receivables of the billing of each of the heath care providers at a substantial discount. Then they charge the full billed price (before discount and sale of the note) to the patient upon settlement or trial verdict.

Advantages: Similar to the doctor lien option, this option allows the needy patient to get quality medical care on credit with no out-of-pocket cost. Additionally, because the intermediary corporation purchases these medical bill receivables, the doctor no longer looks like he is an interested party since he has already been paid regardless of the outcome of the civil case.

Disadvantages: The cost of medical care is nearly always outrageously overpriced. The finance companies' excessive pricing of medical care is often Exhibit A for the defense in trial. Also, these companies often have contractual language that waives a patient's right to question the pricing charged and on occasion they legally pursue patients beyond the proceeds recovered from a trial or settlement. In other words, you may get a settlement and still end up owing these companies money for the balance of their inflated bills.

Conclusion: This method is better than going without care, but it is risky and the contract the patient has to sign is often very one-sided. My grade for this approach is a C.

ALTERNATIVE #3 - Partial Pay/Partial Lien:
This method schedules a periodic payment plan with your physician but carries the balance on a lien.

Advantage: Because the physician is being paid some money, the lien portion of the medical billing tends to be more moderately priced. Additionally, the physician looks less like an interested participant in the outcome since he has already received some money.

Disadvantages: This method requires an outlay of cash. For people with very limited resources, this approach may simply not be sustainable.

Conclusion: Partial payment combined with carrying the balance on a lien tends to make sense to a jury. This option both shows that the patient is a payer and that the doctor is less interested in the outcome. My grade for this approach is an A.

ALTERNATIVE #4 - Financing Medical costs through a Litigation Cash Advance financing:
There are a number of loan companies that will pay you cash advances during the tendency of your injury accident case. These companies do not really care why you get the loan or how you spend the money. Usually, these companies will pay you in advance up to 10% of the perceived value of the personal injury case. This approach contemplates taking out a loan and using it to pay cash for the medical care.

Advantages: Paying physicians on a pre-negotiated cash price for care assures the lowest rates and maximizes your medical bang for the buck. Also, because the doctor is completely paid as you go, when he comes to court testifying in support of injury, he is a completely unbiased witness. He is owed nothing and is not in the least an interested party.

Disadvantage: You have to make sure you do not get taken advantage of when it comes to repaying these loans. Repayment terms and interest rates are massively different from lender to lender. Also, you have to make sure that your doctors give you rock bottom cash discounts. If they do not, you could be paying both inflated medical bills and crippling interest rates.

Conclusion: If you do not have the ability to pay as you treat, this approach can be an intelligent option. This particular approach can be utilized to maximize medical care and minimize inflated medical pricing. Additionally, as long as you repay the loan before too much time has passed, the interest rates are high but manageable. My grade on this method, if done wisely, is an A.

Final Thoughts: Navigating through these complicated medical, legal, and high finance issues has no shallow end. This is complex stuff and anyone trying to figure this out for herself is going to need help understanding medical pricing, interest rates, and she needs to have the stomach for negotiating.

At Anderson Hemmat, we are more than willing to sit down with you at any point during your case to help you make the best and most appropriate decision for your case. Remember, getting no medical care when you are truly injured is much worse than getting expensive medical care.


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