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How Medical Bills Get Paid

Hello, thanks for visiting us on another edition of Claim Your Justice personal injury Q&A, this one is on medical bills. My name is Keith Shindler. I’m an attorney at Claim Your Justice. Over the past couple of months, we’ve had an opportunity to discuss different areas of personal injury law, what to do when a personal injury occurs, how to deal with liability issues, etc.

Today I want to talk about dealing with medical bills in the event of an injury. It could be a small number of medical bills somewhere in the range of several hundred or several thousand dollars. Or, in many of our cases, it’s 10s of 1000s of dollars. The question is, what are you going to do, and how will I help you settle your medical bills?

I want to talk with you about a real-life example. A case recently settled for $100,000, which was the policy limit on the case, and our client had $47,000 of medical bills. My job is to make sure that I maximize the amount of money that I put back into my clients’ pockets. My job is not to collect money and pay the doctors every dollar they billed to my client.

Illinois Health Care Services Lien Act

In Illinois, there’s something called the medical health care services lien act, which gives medical providers certain rights. We want to assume for this topic today that my client did not have any health insurance. All the bills are now the responsibility of my client. I need to make sure that I do my best to satisfy the bills without paying every dollar that the medical providers are claiming.

In this case, we have a $100,000 settlement. My goal is not to pay the medical providers more than one-third of the settlement, which would be $33,000. I want to make sure that my client at least gets one-third of the settlement. Of course, my goal is for the client to get more than that, but under the health care services lien act, medical providers have certain rights.

First, I need to contact each provider and propose a settlement of the medical bill. I want to make sure that any money paid to the provider will completely clear the bill for my client. The last thing I want is to have an $8,000 hospital bill, pay the hospital $4,000, and then my client gets an envelope in the mail from a collection agency saying that they owe another $4,000. I’m not going to let that happen. That’s part of the services we provide to our clients. We ensure protection in many different areas, including medical bill collections.

In this case, we have $47,000. Some clients think, okay, if I have to pay my attorney a third, that’s $33,000, I pay another $47,000 in medical bills, that is $80,000, and now the client may be thinking they are only going to get $20,000. That’s not how we roll here. We work aggressively for our clients to make sure we can reduce their medical bills as efficiently as possible. In this process, it’s not so easy because, as we know, they may have a hospital bill, then a radiology bill, on top of an emergency room bill, all separate from one another. Our staff needs to make sure we contact the right person, negotiate the proper settlement, and get a complete release from each of the providers so that my client knows they are clear of any future collection. Then I can distribute the money.

Health Insurance Companies

Now, let’s take an example where a client has health insurance. Hopefully, most people have health insurance. If your health insurance company pays for your medical bills, which is very frequent, then I need to make sure that the health insurance company gets protected because they have something called subrogation. Subrogation is where the health insurance company makes a payment, but in the policy document, it says when the payment is made for a personal injury case, the health insurance company gets back their payout.

In that situation, I will communicate with the health insurance company. As a quick footnote, if you’ve been in an accident and gone to the hospital, one of the questions they will ask you is, “Are you here as a result of an accident that someone else was responsible for?”. This question is because the provider wants to make sure they communicate with me to get their bill paid.

Going back to the health insurance example, you could have $47,000 in bills, and the health insurance company doesn’t pay the total amount of the bill. The $47,000 may be billed to the health insurance company. The health insurance company has a specific formula they calculate and payout that amounts through their insuring agreements with the providers. In that case, let’s say the bills are satisfied by the health insurance company for $20,000. It seems great, right?

Now, here’s where I come in to help. I’m going to try and negotiate that number down even further. If I can negotiate the $20,000 health insurance subrogation lien down to, let’s say, $15,000, then I pay $15,000 Out of the $100,000. I will pay $15,000 to the health insurance company as reimbursement. I’m going to take our fee of a third, $33,000. Now you have $48,000, and my client can get $52,000 out of the settlement for their injuries.

This topic is not always discussed because it comes up on the back end of a personal injury case when a case has settled, and the attorneys disperse the money to the client for their entitled recovery.

Contact Our Illinois Personal Injury Lawyers To Make Sure Your Medical Bills Are Paid

One last closing message. We’ve had cases where there has been $300,000 worth of medical bills or $250,000 worth of medical bills. The process is generally the same. The reductions are sometimes larger when you have more extensive medical bills. The fact is, I and Claim Your Justice needs to protect our clients once the case has settled to ensure no medical bills hanging over their heads. Thank you for listening. Remember when you or a loved one are injured in an accident, let Claim Your Justice help you. Contact Illinois personal injury lawyer Keith Shindler at 800-885-3484. Have a lovely afternoon, and thank you!

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