Who covers your medical bills when you are in a car collision? Are you required to pay your doctors up front? Does your Personal Injury Protection (“PIP”) insurance benefits cover the bills? Does your private health care insurance provider pay them?
This article outlines who pays your medical bills and in what order. For example:
Ambulance bill: $875
ER bill: $3,300
Family Doctor: $120
Physical Therapy: $3,200
TOTAL BILLS: $7,495
EXAMPLE: You are rear-ended on I-15 near Provo, Utah. It’s not your fault. The at-fault driver was cited for following too close. You are taken by Gold Cross Ambulance to Utah Valley Hospital and admitted. The next day you are discharged with broken ribs and neck and back injuries. You immediately see your family medical doctor who refers you to physical therapy. Thereafter, you do 20 physical therapy visits and finally heal after four months.
Personal Injury Protection Benefits (“PIP”). First, your own car insurance will kick in and immediately pay the minimum $3,000 in medical pay reimbursement. This coverage is on your own car insurance is called Personal Injury Protection Benefits (“PIP”). In Utah your PIP medical coverage can be as high as $10,000. Totally recommended. See this deeper video and article on PIP.
PIP will pay up to their Utah state minimum $3,000 limit for all medical treatment and bills that are reasonable and necessarily related to the Utah car accident. If your bills are around $7,000, $3,000 of minimum Utah state PIP benefits are not enough to cover them all.
It should be noted that the providers that bill PIP first get paid first. The medical bills that are incurred first are not necessarily paid first, especially if their billing departments take a long time to bill your car insurance PIP. Often the physical therapist will get paid by PIP the fastest because they are smaller than the hospitals and get their bills out quickly. You can ask your own insurance carrier for a PIP payment ledger which will detail who got paid, when, and how much. The PIP ledger is helpful in determining which medical providers have not been paid. This is ledger often comes with a PIP “Exhaustion Letter” and is very useful with your own health insurance carrier. PIP medical pay will pay hospitals, physical therapists, chiropractors, medical doctors, etc.
Private Health Care Insurance. Second, only after PIP is exhausted, your own private health care insurance will start paying the bills. Generally, your private insurance will not start paying until you provide them with the PIP exhaust letter and payment ledger. Once PIP is exhausted, then they will start covering your medical expenses.
After a bit of time, it is important to obtain a payment ledger from your own private health care insurance to get a better understanding on who has been paid and when. You can compare the PIP payment ledger to your private health care insurance ledger to ensure that all bills get paid.
Lien-Based Medical Care. Third, you can get your medical care paid for in a Utah car accident by obtaining lien-based medical care. Lien-based medical care is when the medical provider doesn’t get paid until the case settles. Normally, you pay your medical provider using PIP or your private health care insurance. Often people don’t have private health care insurance and their PIP is exhausted. This is an example where you approach your medical provider and ask them to get paid at the end of your personal injury case.
Common lien-based medical providers are chiropractors, physical therapists, pain management specialists, and sometimes surgeons and medical doctors. The good thing about lien-based medical care is that you can get the medical treatment you need and recover, which is the most important part of a personal injury case. The bad thing about lien-based medical care is that you will be charged more for the services. A premium is built into each treatment charge because the provider will not get paid until the end of the case. An example of an inflated lien-based bill is when a normal physical therapy appointment is $75 per visit, but with lien-based treatment, could be $120 per visit. A surgery that would normally be $15,000, could be $25,000. You need to be careful about the care you incur and monitor how much it is costing you. An important note about lien-based treatment is that you will always owe these lien-based providers, regardless of whether you win your car accident case or not.
Cash Pay. Fourth, you can pay cash out of your pocket for medical care and seek reimbursement later from the at-fault insurance carrier via a settlement. Most people don’t use this option because it is very hard on personal finances. Further, there is always a risk you will not receive a settlement in your car collision case.
Lastly, you are ultimately responsible for paying your medical bills that you incur from a Utah car collision. It may be true that you were not at fault and that the other person’s insurance will pay for your bills. However, your medical providers want to get paid and don’t care that you were in a car accident caused by another person.
Medical providers, unless contacted and agree to a forbearance, will send your debt to collections and the credit bureau. You must pay attention to your bills.
WHAT CAN A UTAH PERSONAL INJURY ATTORNEY DO FOR YOU AND YOUR MEDICAL BILLS?
A good Utah personal injury attorney will be monitoring your medical bills and know how much you owe for each provider. You should also be watching your bills and know where they are at because you will ultimately be responsible to pay them.
A personal injury attorney will retrieve every medical bill and every medical treatment record and keep a chronological summary of them. Your car collision attorney will obtain the PIP ledger and the private health care insurance ledger to help you understand which bills were paid and which bills are outstanding.
A good Utah injury law firm can help coordinate lien-based medical treatment when circumstances are right and the client consents and is in need. Surgeries, physical therapy, chiropractors, and pain management are common providers a personal injury lawyer can help coordinate with.
For the insurance defense attorneys and adjusters reading this article, lien-based, attorney-coordinated medical care is not about trumping up a false injury case. Lien-based medical care is generally for the financially insecure and those who lack medical insurance, but still need treatment. Unfortunately, lien-based care is expensive, but it helps people recover.
CALL ATTORNEY JAKE GUNTER (801) 373-6345 for a free consultation regarding your Utah car accident case.