Auto Insurance Claims: Get the Dr Paid and help our patients settle their own calim


Question
How to get a third party claim paid directly to the doctor. I  bill exclusively for Chiropractors, and my biggest problem is to try and get the 3rd party insurance to pay the Dr directly. I personally would rather our patients try and settle the claim out on their own. usually I will try and use the PIP and health insurance first however at times these 2 are not an option and I would like to find a way to try and get the 3rd party insurances to accept a lien /a non-revocable cause of action... or anything that will allow the settlement check to at least include the Dr name. Otherwise our last option is to have the patient retain an attorney and that sometimes is a hassle, not to mention that our bills are cut by 70% of our charges by the attorneys. I guess that is also another question is how to deny a ridiculous reduction from an attorney? As for our patients, what is a good source were I can refer our patients to get more educated on how to settle a claim without the need of an attorney?

Thanks in-advance for your help!

Elizabeth

Answer
Hi Elizabeth,

You have asked several questions. I will try my best to answer in order.

1) 3rd party insurance carriers are not in the business of paying bills. The will generally only make a one time settlement in exchange for a signed release form. This is usually not done until all treatment is completed and the doctor has release the patient from their care. Then it is up to the injured party (or their attorney)to assemble all of their bills, medical files, diagnosis & prognosis into a demand package and send to the insurance company demanding an amount for settlement. That total amount would include all of the medical bills, any lost wages, required home services, mileage to the doctor or physical therapy and pain & suffering. Often the insurance company will then send the medical bills to a medical review company who will then reduce the bills based on diagnosis, efficacy and reasonable & customary rates. All of which are usually made up for the sole purpose of saving the insurance company money. It is usually due to these medical bill reductions by the insurance company that the attorneys then also seek a reduction from you. This is so their client ends up with some money because the settlement they reached is based on the reduced medical bill.

2)There are many sites on the web that can provide self help injury claim info. I do not endorse any specific site but a couple are:  http://settleyourclaimyourself.com/ and  http://www.settlementcentral.com/

I hope this helps
Richard Hixenbaugh