Picture this: you’re hurt in a car wreck, and you assume that your health insurance will cover the medical bills. You even make sure to show your insurance card after an ambulance takes you to the hospital. But the hospital never sends your bills to your health insurance, which would have paid for the care in full at a discounted, contractually agreed upon rate, and the hospital then refuses your requests to do so. Instead, the hospital pursues an amount five times more than your health insurance would have paid by placing a hospital lien on your accident settlement.
This happens far too often when hospitals use old lien laws to increase revenue, usually at the expense of patients with good health insurance. By using hospital lien, hospitals can collect on money that otherwise would have gone to the patient to compensate for pain and suffering. By doing so, hospitals ignore the steep discounts they are required to offer to health plan members, and instead pursue inflated charges. The difference between the two prices can be shocking.
The practice of bypassing insurers to pursue full charges from accident victims’ settlements has become routine in major health systems across the country. It is most lucrative when used against low-income patients with Medicaid, which tends to pay lower reimbursement rates than private health plans.
Hospitals may try to convince you that you don’t want to use your health insurance because someone else caused your injuries, while fully intending to collect more for your medical treatment from your accident settlement. Many states passed the hospital lien laws that were meant to protect hospitals from the burden of caring for uninsured patients, and to give hospitals an incentive to treat those who could not pay medical treatment. But now, hospital liens are most commonly used to pursue debts from car accident victims. Under Texas Property Code 55.002(a), hospitals can file a lien against ‘a cause of action or claim of an individual who receives hospital services for injuries caused by an accident that is attributed to the negligence of another person.’ In simple language, if you are injured due to the negligence of another such that you may bring a claim against them to recover for damages, the hospital can file a lien that attaches to your claim and that must be satisfied, or paid, from any recovery paid on the claim.
However, hospitals are also required by law, pursuant to Texas Civil Practice and Remedies Code Chapter 146, to submit claims for medical treatment to a patient’s health insurer within a proscribed period of time. Failure to do so will result in the hospital’s inability to collect from the patient for charges that would have been paid by health insurance had the claim been properly submitted.
When you are injured in a car wreck, rushed off to the emergency room, worried about your health or a family member, health insurance might be the last thing on your mind. It is important however to provide your health insurance information to medical providers and use the health insurance whenever and wherever possible. Call (855) 524-2976 and let us help you get what you deserve.