If you’ve been in a car accident and had to seek medical treatment after your crash, the minutes and hours after your accident might be one big blur. An ambulance might have been called. Doctors might have given you pain medicine. You might have seen several doctors during the course of your care. While you might have insurance coverage, insurance might have been the last thing on your mind. And while you may have an insurance policy that requires you to see an in-network physician, asking these questions before you received critical medical care might have been far from your mind in an emergency situation.
For some car accident victims, this emergency medical care is essential and lifesaving. If you have health insurance, you might think that the procedures and medical care should be covered by your policy. Sadly, this isn’t always the case. Organizations like Consumer Reports and AARP report that some insurance holders find themselves shocked when they receive surprise medical bills in the mail after receiving medical care or emergency care.
Insured individuals have been receiving surprise medical bills in the mail because of a loophole that insurance companies have been using to avoid paying claims. Some insurance companies only cover medical care provided by in-network doctors. When patients are healthy, they can visit clinics or in-network doctors, or at least ask these questions before they receive care or tests. But in an emergency situation, where an ambulance must be called, or where emergency room personnel must treat the patient, sometimes hospitals and doctors might be considered “out of network” by the insurance company. When the hospital makes a claim with the insurance company and the insurance company denies the claim, the hospital might send a bill to the patient for the amount owed. Because patients are often asked to sign forms that explicitly hold them responsible for bills that go unpaid by insurance companies, patients might find themselves on the hook for medical care they received.
According to AARP, more than 50% of Americans have received unexpected medical bills. In an emergency situation, individuals receiving medical care may have little to no say in where they receive treatment or from whom. If emergency personnel take them to an “out of network” hospital or if an “out of network” doctor sees them, they could face a surprise medical bill. Some of these doctors charge very high rates.
What can you do if you have been sent a surprise medical bill? A new law went into effect in January in Texas that takes patients with state-regulated health plans out of the billing negotiation. Only 16% of Texans have state-regulated health plans. If you have a state-regulated health plan, doctors should not be sending you surprise medical bills. And all surprise medical bills are now illegal if your situation was an emergency. But if you don’t have a state-regulated health plan or if you are seeking follow-up care after an emergency, you could still face surprise medical bills in non-emergency situations for your care. And if you received care before the law went into effect, you might be facing unexpected medical bills, and may find yourself being sent back and forth between your doctor and your health insurance company.
If you have received a surprise medical bill, it can be tough to know what to do next. The hospital or doctor’s office might pressure you to pay the bill or threaten to report you to a collection agency. It can be tough to know whether you might be protected under the new law. Surprise medical bills can be in the thousands of dollars. For families struggling to make ends meet, these bills can be devastating. However, if you have received a surprise medical bill in the mail, it is important to be informed, to understand what you are being billed for, and why. Also, you may have other options under the law.
If you were hurt in a car accident in Texas due to another person’s neglect or negligence, you may have the right to seek damages from negligent parties to cover your medical bills, including unexpected medical bills. The other driver’s insurance may be responsible for paying these bills. Pursuing a personal injury claim after you have had to pay surprise medical bills is one option you might have. Have questions about your rights? The Cooper Law Firm is a Texas car accident law firm that may be able to assist you. Contact us today to learn more. You may only have a limited amount of time to make a claim under the law. Or, reach out to USAttorneys.com to get connected with our car accident law firm today.