The hospital wants to bill the emergency room bill to the driver of the car that crashed into me; that sounds fair, right? WRONG. All injury lawyers know that If you have health insurance and do not have Georgia Medical Payments insurance coverage, then the medical care should be billed to your health insurance after a crash, every single time. “Why” you may ask. “After all it is only fair that the other driver’s insurance company should pay the emergency room bill if they caused the crash.”
1. Your health insurer has a contract fee schedule for services so that a $1400.00 MRI will only be billed to your health insurer at around $500.00. So when time comes to reimburse the health insurer out of your settlement you are repaying less than $500.00 instead of $1400 to the hospital.
2. You may not want to hire a lawyer and bother with trying to make a financial recovery from the other driver. If the hospital fails to bill the driver, they may try to take out a Georgia Medical Lien against you and you end up on the hook.
1. You should always stay on the hospital by calling every week to make sure they are putting the billing through.
2. Call your health insurer and verify it.
3. Get a copy of your car insurance declarations page which confirms that you have no medical payments coverage. You can get this online, call to request it or check the mailing they sent you on renewal.
4. Send a letter like this to cover your backside:
August 2, 2009
Northeast Georgia Medical Center
Attention: Patient Accounts
743 Spring Street
Gainesville, GA 30501
Re: Patient: Mike Smith
Account Number: 1254fh4
Date of Loss: June 24, 2009
Date of Birth: 06/01/1984
Dear Patient Accounts:
I write to confirm that you have my health insurance information and to politely remind you that you are obligated to bill my health insurance for the medical care that I received at your facility. I do not have medical payments insurance on my policy as is confirmed by the attached declarations page from my car insurance company.
As you know, I presented my health insurance card at the time of care and I am attaching another copy for your convenience. I am insured for health insurance with ACME Insurance under policy number 801355236-06 and group 9624970001.
As you know in Georgia, if there is no med pay, then my health insurance is primary. If you fail to bill my health insurance company, you will be in breach of the contract. I apologize for having to be so blunt, but some hospitals are getting bad advice from their collection lawyers who do not understand that the health insurance contract is binding and there is no automobile crash exception. If you fail to submit the bill to the health insurer within the contract period of time, you will have breached the contract.
If you should need any other information to properly process this claim please let me know.