A recent case concerning a local chiropractor’s questionable billing practices brings to light some important questions about the use of a chiropractor following an auto accident and, importantly, how those services will be paid for.
Essentially, when a victim of an auto accident seeks chiropractic treatment for his or her injuries, the payment for that treatment can come either from the patient’s individual health insurance or as a part of the auto insurance claim. Which is better for the patient and which is better for the doctor?
Depending on an individual’s health insurance plan, it might be in the patient’s best interest to have their health insurance company cover the chiropractic services. This is particularly true if the patient’s health insurance has no deductible or a very small deductible, meaning that the use of health insurance will keep the patient from having to pay any money out-of-pocket for medical care expenses in the wake of an accident.
Unfortunately however, the financial interests of the auto accident victim and the chiropractor don’t always align so nicely. In some circumstances, from the chiropractor’s perspective, it is more lucrative if payment for services is taken out of the auto insurance claim. This incentive might exist depending on state law and the specific coverage that the patient’s insurance plans offer. Sometimes, in auto accident cases, the amount of medical expenses that normal health insurance will reimburse to the service provider are reduced by a percentage. This means that you, the patient, won’t pay any money, but the service-provider may not receive the full amount from the insurance company. In other words, an injured car crash victim’s health insurance company may pay 60 cents on the dollar for chiropractic care. The Chiropractor may prefer to NOT bill the valid health insurance, but instead put a "lien" on the car crash case by having the patient and/or the patient’s l;awyer signan "Assignment of Proceeds" (like an "IOU") so that they can get paid 100 cents on the dollar a year or two later. However, by definition, this takes money away from the patient’s net recovery where their health insurance would have paid and there was no deductible.
Some chiropractors mislead patients and tell them they will bill their health insurance, and that signing the "Assignment" is "just in case." Still other chiropractors will bill the patient’s OWN car insurance medical payments coverage rather than the valid health insurance in order to get more money, even though the disabled patient might need those limited funds to pay deductibles or for treatment not covered under their insruance plan. And still chiropractic practices fail to bill the health carrier in a timely fashion, leaving the injured patient no alternative but to pay "full freight" or be sued by the chiropractor.
Read in tomorrow’s post how to take control of this situation and ensure that you get billed as you wish.