Wiki Motor Vehicle Accident Billing ?

[JMichelle]

Hello, this has been an ongoing issue in our small orthopedic office for a while... We have an office policy where we do not file personal insurance for MVAs, because when we do, the insurance ends up recouping later on. Therefore, we file no third part companies.

So we make patients pay up front and become self-pay with our office. There's a LOT of confusion on the patient's end about this and we are trying to make this whole situation simpler and provide resources for the patients so they can understand.

They usually end up calling their insurance company, who tells them that we CAN file, so they end up very frustrated with us.

We understand that they are suppose to be receiving a settlement from the at faults autoinsurance, which is suppose to be used to cover their bills, but in the meantime they can't afford these bills. Plus we can't be certain that they will pay us back once they settle. What are these patients suppose to do? We are the ONLY orthopedic facility in this area that even accepts auto accidents...

What can we advise our patients? We already offer care credit to pay their medical bills in the meantime, I'm wanting to put together a pamphlet or resource on our website to provide further information for our patients. Thank you!

 

[Chelle-Lynn]

Since this is an internal office policy and not a mandated rule (ex: by Medicare or insurance commissioner, etc) I would recommend the following:

- Provide a professional and short reasoning as to why your office will not bill third party companies. This will help to explain that you "can" bill the
carrier by "choose" not to for the following reason...
Example: Not contracted, difficulty or delays in receiving reimbursement, etc
- Make sure to provide the patient with a copy of their HCFA each time they leave so that they can quickly submit the claim to their insurance for
reimbursement. This will require that the front and back office communicate quickly to ensure that all of the charges are listed for the patient prior
to leaving.

Other than this your internal office policy will continue to upset your patients. Unfortunately that is the nature of medical billing and the impact of your office policy. I am not sure that there is a way around this. Make sure that all communication is provided verbally and in writing. You may want to consider collecting from the patient at the time of service, but as a courtesy billing the third party carrier on behalf of the patient without assignment.

 

[daedolos]

Just curious, but has anyone ever heard that Medicare will generally not accept motor vehicle accident claims?

Peace
?_?
I just got off the phone with an auto insurance carrier and they were originally designated as secondary insurance and the operator said in general Medicare will deny auto accidents. I bring this up because the auto insurance carrier denied the claim because they weren't billed as primary.