After the shock and trauma of a serious accident is over, you’re left dealing with the pain and suffering of physical injuries and automobile damage. When you factor in the burden that comes with dealing with the at-fault party, the police, and insurance companies, you’re faced with a very stressful situation. And then the medical bills start rolling in.
It’s hard enough to pay the exorbitant fees for an ambulance, hospital or emergency room visit, X-rays, labs, and specialists as it is, especially if you’re hurt and out of work as a result of your accident. Personal injury claims can take months and, in extreme cases, sometimes even years to resolve. What are your options for paying these often excessive medical bills, and how can you afford to get the treatment you need to get better and build your case? A personal injury lawyer can help.
Medical Bills Are High Enough Without Inflated Costs
The US is known for having some of the highest healthcare costs in the world. In fact, a day spent in the hospital costs $5,220 in the US, but only $424 in Spain. An MRI can cost up to eight times as much in America as it would in Switzerland. That’s why even a relatively straightforward injury could tip your medical bills into the tens of thousands of dollars if you go to an emergency room.
These steep charges are a result of negotiations between hospitals and health insurance companies. Health insurance companies will often cover only a small percentage of a hospital’s charges, so hospitals will inflate their charges so that insurance companies will pay more on a claim.
This cost gap becomes your burden through increased deductibles, copays, and health insurance premiums. In some instances, the hospital will refuse or fail to even bill your health insurance, exposing you to inflated bills. Worse, many Texans are hit with surprise balance bills from out-of-network hospitals or medevac services.
Unfortunately, Texas is notorious for surprise emergency medical bills and inflated hospital charges. A recent national study showed that several Texas hospitals were among the worst offenders for inflated hospital bills. A hospital analysis created by the Center for Public Policy Priorities (CPPP) found evidence that Texas ER patients are regularly attended to by out-of-network physicians, even when the hospital itself is considered in-network by the patient’s insurance provider.
This results in so-called “surprise medical bills,” when an insurance provider and doctor disagree over medical costs. The difference between these costs is typically passed directly to the patient.
Recent Changes to Texas Law Give Attorneys More Power to Dispute Medical Bills
Those without legal advocates often wrongly assume that there is nothing they can do about high medical bills or out-of-network charges. In fact, nothing could be further from the truth. Over the past decade, the Texas legislature has introduced several changes to the law that protect patients from unexpected or inflated emergency medical bills.
In fact, at the time of this writing, the Senate just passed a bill directed towards protecting patients from surprise balance bills. At the same time, a Texas Supreme Court case, In re North Cypress Medical Center Operating Co., Ltd., has given legal professionals more leverage to negotiate inflated hospital bills and more insight into the billing process.
More specifically, Texas hospitals are now required to list costs for medical procedures online, meaning those prices are clearly documented for patients and legal representatives. Additionally, in 2009, the Texas legislature developed a mediation system for patients to dispute out-of-network care costs.
Unfortunately, this mediation system can be difficult to navigate; the same CPPP analysis uncovered that only about 3,824 patients have been able to access this system. They anticipate that roughly 250,000 Texans will receive a surprise out-of-network bill over the next two years, and may not dispute it, even though they may be eligible for mediation.
Part of the reason for those undisputed bills is that medical charges are purposefully opaque. Patients hurt in accidents are often forced to “decode” medical bills in order to understand exactly what they’re being charged for. Additionally, even if patients are able to make sense of these charges, they’re typically uninformed about their options for mediation and negotiation.
To add to the issue, hospitals and freestanding emergency rooms often intentionally inflate medical costs, sometimes adding thousands of dollars in unnecessary charges to patient bills. They may resist bill negotiation, refusing to produce documentation that would justify those costs.
The In re North Cypress case makes this practice painfully clear for those providers. In that case, an uninsured accident victim was issued a hospital lien that listed exorbitant fees for hospital treatment.
When her legal representatives attempted to obtain records documenting costs for similar treatments for insured patients, the hospital refused to cooperate. The case went all the way to the Texas Supreme Court, where the court ruled that the patient and her attorneys should be able to access this information, as it was relevant to her case in determining whether the hospital lien was valid.
This case underscores just how crucial legal representation can be to altering the results of your case. Through creative lawyering and a willingness to fight, the claimant’s lawyer was able to force the hospital to the bargaining table to resolve the outstanding bill for a reasonable amount.
How a Personal Injury Lawyer Will Help
A personal injury lawyer is a valuable ally in any personal injury case, particularly as it pertains to your medical bills. Lawyers are familiar with medical billing practices and can help you understand those charges. We also understand common techniques medical providers use to inflate hospital bills, including unclear fee structures, unnecessary treatments, and “chargemaster” pricing—using a computerized billing system that charges patients the full amount for all emergency services rendered, rather than the discounted price offered to insurance companies.
Hospitals, while offering vital medical treatments to emergency room patients, are also in the business of profit. Hospital billing departments bet—often correctly—that accident victims will not dispute charges and will not understand how to fight for fair pricing. Hospitals also often rely on hospital liens to attempt to secure their right to payment of an inflated bill by hijacking your settlement, rather than submitting the bill to the patient’s health insurance. This practice is predatory and can be fought.
This is exactly why an attorney can be so useful in obtaining more reasonable medical charges. Your attorney will pressure hospitals to obtain an itemized list of the charges and then determine which costs have been inflated.
Then, he or she will fight to eliminate or drastically reduce them to reflect their actual value. Finally, your lawyer will look for evidence of double billing, which occurs when a healthcare provider attempts to bill both you and your insurance for the same treatment, or when a provider tries to charge more than once for the same service, often by using an individual code once, and then again as part of a bundled set of charges.
When your life has already been disrupted because of an accident, the extra burden of medical debt can take a real toll on your health and financial well-being. Don’t let the financial crisis of post-accident bills overwhelm you or interfere with your recovery. Here at FVF Law, we’re sincere in our efforts to advocate for your rights and achieve the outcome that you deserve. That’s why we invite you to meet with us and discuss your case completely free of charge. Get in touch with us today, and let us help you rebuild your path to recovery and success.
