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Why Wasn’t My Health Insurance Billed at the Hospital?

Posted: August 5th, 2013 | Author: Austin-Personal-Injury-Blog
Categories: Personal Injury Blog

Why Wasn’t My Health Insurance Billed at the Hospital?

After sustaining an injury that required medical treatment at a hospital, patients oftentimes receive the hospital bill shortly thereafter. However, even if patients had health insurance at the time of the incident, it’s quite possible that the bill you opened up in the mail is larger than expected. Usually, this is the result of the hospital not billing the treatment through your health insurance.

When a hospital finds out that a patient with health insurance has been in a car accident, they know there are likely two ways the patient can pay. The first option is to bill the care through health insurance. In this scenario, the hospital is receiving a reduced rate from the health insurance company from what someone would pay if they weren’t billing through health insurance.

In the second scenario, they bill the ‘uninsured’ amount, regardless of whether or not there is health insurance involved, and hope the patient pays the bill. This would be a poor business practice in most situations; however, when a hospital believes a car insurance company will potentially pay them back, hospital may fail to bill health insurance and hope they get paid in full by the responsible party’s car insurance company.

There are pros and cons to the methods of billing that the hospitals are employing. On one side, you can use the high bill in order to settle with the insurance company, and then negotiate the bill with the hospital afterwards. On the other hand, most health insurance plans only allow you to submit bills within a certain time period. If the personal injury case doesn’t work out with the car insurance company, by not forcing the hospital to submit the bill to health insurance right away you risk being stuck with a large bill that neither health insurance nor car insurance will be paying for.

If you have questions regarding health insurance or hospital payments after an injury, please call an injury lawyer at Zinda Law Group for a free consultation.