- February 28, 2020
We want to talk about something that people ask about all the time – how do my medical expenses get paid in my personal injury case? Here is a simple example of a case where we make a recovery for a client of nine thousand dollars. Our fee would be one third, as you know we work on a one third contingency fee basis on almost all of our cases. That would then leave the client, with gross proceeds of six thousand dollars. Out of the six thousand dollars, the client is going to have to pay back any unpaid medical expenses, or reimbursements to insurance companies, like a health insurance company, who has paid their medical bills that have to do with this injury case.
Now let’s talk about the medical bills, say for instance in this case the client has one medical expense, an ER bill of five thousand dollars. If the client has no health insurance, they probably cannot afford to write the hospital check for five thousand dollars, so the hospital is going to take a lien on their case. When we make a recovery for the client as we hope to, we will then, with the hospital’s lawyers, negotiate that lean down. Say for example, we negotiate that lien down to four thousand dollars, the client would take two thousand dollars in their pocket. Let’s say for instance the client has Blue Cross health insurance, the client must make sure that ER bill is submitted to their health insurance company. The health insurance company is going to discount that bill, and pay three thousand dollars. The reason that is important is because it gets rid of that five-thousand-dollar hospital bill, and now we’re left with Blue Cross, of course Blue Cross wants their money back and they probably have a right under their contract to make that recovery, it is called a claim for reimbursement. Blue Cross then will make their claim for reimbursement we are also going to negotiate with Blue Cross, let’s say we negotiate Blue Cross’s claim down to two thousand dollars, the client is then left with four thousand dollars in their pocket.
Now here’s the most important thing I want you to take out of this, if you have health insurance, and this might sound illogical. But if you have health insurance when somebody else caused you an injury if you have health insurance make sure all of your bills are submitted to our own health insurance company, it will work out the best for you in the end if you do that, so you give your providers your Blue Cross card, say for example, and make sure that you’re bills are being submitted and paid, the other thing you can do is get on to your Blue Cross site to get a pin number and follow the bills along and make sure those bills are getting paid. Because when they get paid, there’s a discount taken and that discount is to your advantage. Stay safe and be well.