A Guide to Negotiating Medical Bills After Settlement

Category: Personal Injury

Article by Daniel J. Tuley

Before settling a personal injury claim, you should have calculated all of your expenses including any potential future expenses. One of the most important expenses to consider is medical bills. Unfortunately, medical bills can accumulate rapidly and become difficult to manage. 

However, with the right planning and negotiation tactics, you can significantly reduce your medical expenses. If you don’t approach medical bills with the right strategy, it can consume most of your settlement funds. 

This blog will equip you with several negotiation tactics you can employ to help lower your medical expenses.

Pre-Settlement and Post-Settlement Medical Bills

A  personal injury claim involves two types of medical expenses: those incurred before the settlement and after the settlement is finalized.

Pre-Settlement Medical Bills

Pre-settlement medical bills refer to medical expenses incurred before settling. The defendant is not responsible for these expenses until the case is resolved, which means the plaintiff or their insurance must cover their own pre-settlement medical bills. 

Most people have access to health insurance through employers, personal plans, Medicare, or car insurance policies. These policies may have an out-of-pocket maximum, which means expenses are covered 100% after reaching the limit on your deductible. The average out-of-pocket maximum is $4,039, but it varies by policy. 

Remember that you’ll likely have to pay back insurers after receiving a settlement through a process known as subrogation, which is when an insurance company is reimbursed for money paid out to its insured. This process could also apply to medical payments from car insurance policies and any worker’s compensation.  Subrogation is a contractual right the insurers have to be paid back what they’ve paid on accident-related medical treatment.

Additional Pre-Settlement Expenses

In addition to medical bills, you may have other expenses before settling. These can include lost wages from missed work, the cost of hiring help for tasks you can no longer do, or transportation costs such as ride-sharing apps. Often, individuals may rely on savings or family support to help cover these expenses. 

If these options are not available, you may be able to access pre-settlement loans from funders who believe the individual will receive compensation for the injury. However, it’s critical to be cautious with these advances as they often come with expensive fees that will reduce the overall settlement amount.

Post-Settlement Medical Bills

After you receive your personal injury settlement check, your attorney will pay any debts associated with the claim before releasing the funds to you. These debts may include outstanding liens for unpaid medical bills, reimbursements to the individual’s insurance company, and other expenses.

The attorney will also deduct their legal fees from the remaining settlement funds, which are typically a percentage of the damages granted and other expenses such as hiring expert witnesses, filing fees, and expenses incurred while gathering documents and evidence.

After these debts and fees are paid, the individual can deposit the final check into their bank account and use the funds as they see fit.

How to Negotiate Medical Bills After a Settlement 

Negotiating medical bills is important in a personal injury case because medical expenses can make up a significant portion of the overall damages. By reducing the cost of medical treatment through negotiation, you can increase the amount of the final settlement. 

Here are some strategies to help lower your medical expenses:

1. Negotiate Before Treatment

Negotiate with your health provider before you receive treatment. Obviously, this isn’t possible in an emergency, but you can certainly attempt to negotiate the costs of any follow-up treatments. Additionally, negotiating is more effective if you shop around for doctors in your network who offer similar services. This task is challenging because billing is rarely straightforward. You’ll need to speak with patient accounts or billing. You can also use services like the Healthcare BlueBook or New Choice Health.

Additionally, Indiana pricing transparency laws may help. Ambulatory Surgery Centers (ASCs) are required to provide Good Faith Estimates upon request. The federal hospital transparency rule requires hospitable to provide accessible pricing information online about items and services.

2. Ask for Discounts

Healthcare providers may offer discounts on medical treatment to self-pay patients or those who pay in cash because it can benefit their practice. It can help them to increase their cash flow and reduce the burden of unpaid bills. They might also offer discounts to patients who prove they cannot afford services if you explain your situation. 

3. Seek Forgiveness and Financial Assistance

If you still cannot afford your medical bills, don’t be afraid to ask for help. Start by reaching out to the billing department of your healthcare provider and asking about their forgiveness program or any other financial assistance programs they may have available. Some healthcare providers offer discounted or free services depending on your income and other qualifying criteria. In most areas, free clinics offer discounted or free medical care if you do not have health insurance. Finally, seek out local nonprofit organizations, which often provide low-interest loans, grants, and other resources to help with medical bills and those in need.

4. Request an Itemized Bill and Check for Errors

You should contact the number on your original bill and request an itemized version. It is mandatory for hospitals to supply the information when requested. Understanding these bills can be overwhelming, but there are some key elements you should examine.

First, you’ll find your billed charges at the full rate. However, insurance companies always negotiate a lower cost for medical bills. If you do not have insurance, you should negotiate too. Start by checking if you qualify for discounts typically offered to insured patients. 

Then, you’ll see the amount paid by the insurance company and the balance you owe. 

To check your bill, start by doing the math and ensure the balance matches the billed charges minus the insurance adjustment and payment. Then, you’ll review all the codes to look for duplicates. Finally, you’ll look for any services that might not be accurate for the treatment you received. If you find errors, call the billing department and explain the problems with your bill.

5. Appeal the Billing Charge

If you feel like you’ve been overcharged after reviewing your bill, you can appeal it. You’ll start by talking to the billing department at the hospital. Next, you can contact your insurance company (they don’t want to overpay either). You can also contact a patient advocate who may be able to help resolve any billing discrepancies or negotiate on your behalf. Lastly, if you can’t reach a resolution, you can contact your State Insurance Commissioner to file an official complaint. 

6. Hire a Personal Injury Attorney or Talk with a Professional Negotiator

Consider talking to a professional negotiator if you can’t settle your medical expenses alone. These services usually charge a percentage of whatever savings they obtain. So if you submit a bill for $10,000 and negotiate it down to $7,000, they might charge you anywhere from $750 to $1,050 for the work (25%-30%). Even better, if you hire a personal injury attorney, you’ll have a professional negotiator helping you with your case and medical bills.

7. Request a Payment Plan

While a payment plan might not reduce what you owe, you can use this strategy to make it through the pre-settlement phase of your case. Ask if the hospital will accept payments on the bill over time without accruing interest charges. This is much cheaper than a medical loan or pre-settlement funding loan. 

What if My Medical Bills Are More than My Settlement?

If your medical bills exceed the amount of your settlement, you will be responsible for paying the remaining balance. It’s also helpful to speak with a personal injury attorney who can guide you through the legal process and help you get the compensation you deserve. 

Also, if you are unable to pay the remaining balance, you may be eligible for financial assistance programs. Or talk with your healthcare providers—they may offer payment plans to help you pay your medical bills over time, so it’s easier to handle.

How to Document Medical Expenses for a Personal Injury Claim

If you have been injured in an accident, keep detailed records of all medical treatments, medications, doctor visits, and bills. This will help you prevent owing more in medical debt than you received in your settlement. It will also help your legal team prepare a strong case. 

Here is what you should document and how: 

• Keep All Medical Records: The first step is to keep all medical records related to your accident, including doctor’s notes, prescriptions, hospital bills, physical therapy bills, and other medical documents related to your injury. This is important for both your legal team and the insurance company since it will help determine the extent of your injuries, and their impact on your daily life.
• Request Copies of Your Medical Bills: Your doctor’s office or hospital should be able to provide you with copies of all medical bills related to your injury.
• Track Expenses and Lost Income: Beyond medical bills, you should also track all additional expenses like travel to doctor’s offices, any income losses (like missing work for doctor visits), or additional services you had to hire to help while you were injured (like babysitting or lawn care).  You want to document the full extent of economic damages and ensure that you are adequately compensated for all losses.
• Create a Detailed Spreadsheet: A detailed list of all medical expenses can be beneficial in negotiations with an insurance company or defendant. Your list should include the service date, provider’s name, costs, and applicable insurance coverage.

FAQS

How much time does it take to negotiate medical liens?

It’s difficult to give an exact time frame for how long it takes to negotiate a medical lien. It can depend on various factors such as the complexity of the case, the number of healthcare providers involved, and the severity of the injuries. However, it’s important to keep in mind that the negotiation process can be time-consuming. 

Having an attorney with experience in personal injury law can help speed up the process and ensure that your medical bills are negotiated in your best interest. The attorneys at Tuley Law can negotiate with healthcare providers on your behalf to lower the cost of your medical bills and set up a payment plan that is affordable for you.

Is pain and suffering different from medical payments?

Medical payments refer to the actual monetary expenses incurred due to an injury, such as hospital bills, doctor visits, and prescription costs. You can document and quantify these expenses and claim them as part of a personal injury settlement.

Pain and suffering, on the other hand, refers to the emotional and physical distress that a person experiences. It includes things like emotional trauma, loss of enjoyment of life, and physical pain. Pain and suffering is a non-economic damage, meaning it can’t be quantified in a specific dollar amount. It is also more difficult to prove. 

An attorney can help you determine an appropriate value for your pain and suffering damages by using factors such as the severity of your injuries, the impact on your life, and the duration of your recovery.

Hire an Experience Personal Injury Attorney

Negotiating medical expenses is a crucial aspect of personal injury cases. With the right approach, you can significantly reduce the cost of medical treatment and maximize your settlement.

The experienced legal team at Tuley Law has decades of combined experience in personal injury law and can help guide you through the process and ensure that your medical bills are handled in your best interest. Contact Tuley Law today for a free case evaluation by calling (812) 625-2113.

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