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Once Again A Doctor Refuses To Bill Health Insurance

On Behalf of | Jul 23, 2014 | Car Accidents |

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We represent people who have been injured. Most of our clients have been hurt in car accidents or other motor vehicle accidents. In every case, they require medical treatment.

If they planned ahead, they may have Personal Injury Protection (PIP) coverage through their auto insurance. However, if they don’t have PIP, or if the PIP is used up, their treatment may be billed to their health insurance.

With increasing frequency we are encountering doctors who refuse to bill our client’s health insurance, even if they are contracted providers. They refuse because the health insurers pay at a reduced rate, requiring the doctor to take a contractual reduction for every charge.

While the doctors’ motivation to escape the requirements of their contract with the insurance company is understandable, it is also not allowed, and is a direct violation of their patients’ rights. When a doctor signs a contract with a health insurer he gets the advantage of referrals and being listed on that insurer’s website. The flip side is the doctor’s obligation to accept a reduced rate of payment.

In this case, we contacted the health insurer. We confirmed that the doctor is in fact a contracted provider and that he is not allowed to pick and choose which bills get submitted to insurance. The insurance company said they would have their Provider Relations department reach out to the doctor. Finally we sent a letter to the doctor advising him that he was required to submit the bills to the insurance company and that if he refuses to do so, and the bills are ultimately denied for untimely submission our client’s patient responsibility will be reduced to zero.

Most injured people don’t know they have a choice regarding how their medical treatment is billed and they don’t know all their rights. That’s where an experienced personal injury lawyer can help.

If you have questions about your medical bills, insurance or any other issues regarding personal injury claims, check out our website or give us a call. We’ve been handling car accident and other injury claims for more almost 20 years and we’ve helped thousands of people just like you.