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Autp Insurance vs Med Ins

  1. Default Autp Insurance vs Med Ins
    Medical Coding Books
    I need clarification!

    We had a patient come in who had been in an auto accident the previous evening. He said that he didn't want to file a claim with his auto ins (he said he didn't want them involved) and he wanted to file the claim for this OV with his med ins. I told him he his med ins would not pay for it because it was a MVA. Was I correct? Thanks in advance for your advice!

  2. Default
    Yes, if it is auto, it is auto and he has to file a claim, you can not file a claim to medical knowing as the provider that it was an auto accident. Tell the patient they either have to open up a medical claim under auto or pay the bill in full. Usually if people dont want to open up an auto claim, there is a reason and it is usually a fraudelent one.

  3. #3
    Columbia, MO
    You can bill it to the medical in our state but you must have the E code that identifies this as an auto accident and the claim has a place to mark if this was due to accident. Then the medical can decide to pay or deny due to third part liability. Auto insurance does not pay for everything if the injuries are extensive. But you do have to include the information to the medical that this is an auto related injury.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
    Tacoma, WA
    That's true Debra. You can file the initial claim with the medical insurance carrier, you just make sure the correct information is on the claim regarding the accident. What will happen is the medical insurance carrier will send the patient a letter asking them to complete an accident report form with information about who else might be liable for payment of the claim. Sometimes medical insurance will pay claims and then go after reimbursement from an auto insurance carrier.

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