Medical Billing Errors In The Personal Injury Case

We all seek medical care for one reason or another and in a serious situation, we never think about the repercussions we may face later on when receiving the bill for treatment.  In reality, many medical bills contain errors that could end up wrecking your credit score.

A recent University of Minnesota study on medical billing estimated that 30%-40% of bills contain errors. Not only can billing errors lead to higher costs for consumers, they can also sabotage a borrowers’ ability to get mortgages or other types of loans.  According to a recent study by the Federal Reserve, medical bills account for more than half of all debts in collection.  In addition, medical bills sent to collection in error are becoming the single greatest threat to credit scores.

The majority of healthcare providers currently use electronic health records and while there are many benefits to the electronic system; these systems are also the major source of billing mistakes.

Any unpaid debt can take points off a person’s overall credit score.  What is even worse is often times people don’t realize they have unpaid medical debt until they go to apply for a mortgage or a loan and get declined due to unpaid medical bills.   Often times people with otherwise pristine credit do not even realize their credit has been tarnished by unpaid medical bills until it is too late.

Billing errors are often correctable, as patients frequently discover.  Often times with medical insurance, patients are under the assumption any medical bills are covered by their insurance carrier.  However, months later, the patient can end up receiving a call from a provider’s billing department claiming an outstanding balance.  A good practice to follow is to always follow up with your insurance company to see whether the medical claim was ever submitted.  Mistake by clerical billing staff sometimes leads to medical providers attempting to bill the incorrect insurer resulting in a denial of claim by the insurance carrier.

It may take some legal work; however, there are ways to fight billing errors and ensure they don’t destroy your credit.  Here are some tips:

  • After a patient receives treatment, the medical provider generally charges the patient’s insurance company and any remaining balance, is often the patient’s responsibility and is otherwise known as a co-insurance.
  • Sometimes, although rarely, healthcare providers bill patients for care, even when care wasn’t received. This can be due to a process or method in a medical provider’s office which is not intentional, but simply an oversight. This can happen, for example, if a billing clerk has been told to bill on the basis of a doctor’s appointments and consultations simply using the doctor’s schedule appointments, without verifying whether the patient received the care.   This is why analyzing your medical bill is extremely imperative; unfortunately, patients can be overwhelmed with this task.

If you have recently received medical care for injuries you sustained in an accident and were represented by an attorney, your attorney should have contacted your healthcare providers to be sure there was no remaining balance on your bills.  It is however your responsibility to provide your attorney with copies of all medical bills you receive for services rendered pertaining to your accident.

If you were not involved in an accident and sought medical care for another situation, it is imperative that you review all bills received as well as keeping thorough records of all payments made.  A good practice is to request a periodic explanation of benefits from your insurance company that will illustrate the money they paid on your behalf and will also document any co-pay you made to the healthcare provider.  This document can be useful in avoiding any discrepancies with medical bill payments.

If you are still in a situation where you have a dispute over a medical bill, contact an attorney if the facility continues to allege you are responsible for the bill and/or threatens to make a note on your credit report. An experienced attorney is more likely to be able to settle the dispute quickly and effectively.