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Health Care Provider Claims on Personal Injury Settlements

July 31, 2022

Personal injury claims usually work to recover compensation that can be used to pay for medical bills associated with the plaintiff’s injuries. Yet, quite often, the health care providers themselves will file their own claims against the defendants in your personal injury claim. Through these claims, they can assert that they be at the top of the list of recipients for any damages won through the claim.

Because the health care provider will likely reach out to your Denver injury attorney when they file your claim, it is important that you actually have an attorney to respond. This can ensure that everything is fair throughout the process. Here’s how health care provider claims on personal injury settlements work.

Health Care Provider Claims on Personal Injury Settlements

Providers Will Seek Direct Payment

Health care providers are experiencing massive declines in revenue due to the care they provided often being uncompensated. Therefore, these providers have begun to make claims against the personal injury settlements filed by their patients. In doing so, they increase the chances of them actually recovering the costs of the care they deliver. In instances where individuals would rather spend the money they win in a settlement on something other than their medical bills, this has been proven to be a reasonably effective strategy for health care providers.

Health Care Provider Claims and Liens

When you engage with a health care professional after being injured in an accident, they will usually present you with a list of questions that are designed to provide them with more information about how the injuries you suffered occurred. If another person or entity is listed as the reason for the injury, they may realize that another insurer is liable for your medical expenses. Sometimes, the questionnaire will even directly ask if another party is responsible for your costs.

Though, hospitals frequently use third parties to collect this information as well. They pay these vendors to find out who is liable for your medical expenses, then that vendor will also file a claim on their behalf. Once it is clear who is responsible for the accident, the health care provider files a claim against those parties. Usually, these claims take the form of liens, meaning the providers’ claims must be prioritized rather than other payments.

Having a lien on your personal injury settlement implies that you may not be the first one to receive money from a successful personal injury claim. Instead, the health care provider that placed the lien would be paid first. Technically, your attorney is legally required to honor any liens placed against your settlement, so there is no getting around it.

Watch Out for Balance Billing

If you are a member of a managed care network, your health care providers should agree to take a discounted payment if they are members of that network. This ensures that health insurance providers receive lower rates from health care providers. Though, this also puts patients at risk of being the victim of balance billing.

Balance billing occurs when the health care provider places a lien on your personal injury settlement rather than filing claims to your insurer. Doing so allows them to recover more money in many cases. Therefore, you need to watch out for health care providers that maliciously file liens rather than accepting the discounted rate approved by your insurance plan.

Hire a Lawyer

If you are not sure whether you have been subject to balance billing or not, a lawyer can help you get to the bottom of it. Hiring an attorney can help you ensure that you collect the maximum amount of compensation possible, so do not hesitate to enlist the help of a lawyer today.

You can reach a skilled attorney by using the contact form on this page.