Balance Billing or Provider Liens: An Important Note on Personal Injury Settlements

If you are fortunate to have health insurance, you may still be held liable for a portion of the cost of your medical care for injuries suffered as a result of an automobile accident. This is because the amount of money paid by your insurance company for your post-accident care is generally less than the amount billed for your treatment. Due to the nature of your injuries and the care provider’s knowledge that you will be receiving a financial settlement from the at-fault driver’s insurance, many medical providers will place a lien on your case. This type of lien is referred to as a balance billing lien. The balance billing lien is for payment of the difference between what the insurance paid your medical provider and what the original cost of your care happened to be. For an illustration of how this works with personal injury cases, see below:

For example:

If you have health insurance, go hiking and break your ankle – your hospital bill could be $5,000. However, because of your coverage, the health insurance company may pay the hospital about $1,500 instead of the full price – as per their agreement with the health care provider. Aside from any co-pays you might have, the $1,500 is all that is paid to the hospital and the rest of the debt is written off per their contract.

However, the responsibility for payment changes if you are injured in a car accident and break your ankle. Like the example above, let’s assume your hospital bill is $5,000. In this situation, your health insurance would still pay the $1,500, as per its agreement with the hospital. However, the hospital may still demand the remaining $3,500 from you since the injuries were caused by a third party.

Balance billing liens are a relatively new form of recovery for medical providers who, in the past, received payment from the insurance carriers via their contracts and wrote off the balance. Since there is a third party at fault for the injuries for which they provided medical treatment and incurred expenses, many medical providers have looked to balance billing liens to recover the full value of their services. Although they are entitled to recover the full balance of their liens, many providers are willing to negotiate and compromise their liens.

A knowledgeable and experienced attorney can help negotiate your liens for you at no cost when he or she is representing you on your case. If you find yourself injured in an automobile accident, contact Pak & Moring for a free consultation to discuss your situation.We can help.

For further information of that the personal injury process is like given your type of medical coverage see

(Please note: while informative, these posts are not intended to be formal legal advice and should not be solely relied on as a primary basis for legal action.)

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