Lien and Health Insurance coverage

[PleaseHelpMe111]

What is the name of your state (only U.S. law)? Oregon

I am on a lien. My health insurance should cover some of my treatment. Are my health care providers required to bill my health insurance first, instead of billing through the lien? Can my health insurance deny, can my providers deny?

Thank you!

 

[FlyingRon]

I don't know what you mean by "on a lien."

Anyhow, here's how it goes. If you have medical insurance coverage, the medical insurer will want any money received from the auto insurances involved or recovered from the at-fault party to be used first. If you make out of pocket medical payments, and the insurer (or a lawsuit) recovers from the at-fault party, then you should be reimbursed (if there is a sufficient amount recovered).

 

[PleaseHelpMe111]

Let me see if I understand this correctly.

Lien meaning I was hit by an at fault driver, who does not have insurance. I don't have PIP, but I have uninsured motorist coverage. Hence, signing a lien so I would not have to pay out of pocket fro treatment.

For example if my uninsured motorist coverage is for $10,000. And my medical bills are $12,000 before using my health insurance ($6,500). I would owe $6,500 to the health insurance company instead of my providers. But if in that $12,000 I paid $700 out of pocket. Then I should get reimbursed for that $700.

Correct.

One of Physical Therapist is billing my health care insurance and are forced to because I don't have PIP. Meaning they are not billing it like an MVA.
They said that I would not have to pay that back. Meaning if I get my old Physical Therapist to do so, and not bill like an MVA then I wont have to pay it back. Leaving $5,500 in medical bills at are covered by the $10,000 compared to the $12,000.

I hope theses numbers make sense. Remember this is an example.


Thank you!

 

[PayrollHRGuy]

No medical provider is required to bill in any certain way other than allowing you to hand them the cash when the service is provided. Anything more they do is pretty much out of kindness.

 

[PleaseHelpMe111]

Lien and health insurance reimbursement

In some states they decide by; how much a health insurance company will reimburse the doctor if he or she performed the same medical care. Laws very from state to state regarding medical liens.

What about in the State of Washington?

Thank you!

 

[HighwayMan]

What about in the State of Washington?

Why do you care about Washington? You're in Oregon.

 

[quincy]

PleaseHelpMe, please add additional questions relating to your car accident to this thread instead of starting new threads. It helps us help you better. Thank you.



Here is a link to your other current thread:
https://forum.freeadvice.com/medical-health-care-malpractice-72/sue-medical-malpractice-637937.html

 

[cbg]

Whether or not your health care providers are required to submit claims to your health insurance at all, let alone in any particular order, depends on the terms of your health insurance contract.

 

[PleaseHelpMe111]

What is the name of your state (only U.S. law)? Washington State.

My chiropractor believed I was my own primary care. Is this legal? I was injured and seeked care from him.

 

[PleaseHelpMe111]

Forgery

What is the name of your state (only U.S. law)?
Washington State.

It's obvious that a doctor forged my signature on legal documents that state I would pay him/establishment in full. This signature they are stating is done on a computer. There are obviously differences in the signature that I will not go into detail about. Some obvious things are shapes letters are formed and what not. I always sign my middle initial, excetra.

The establishment is stating that since it was done on the computer electronically that it going to be altered. It is beyond altered and looks just like my practitioners handwriting.

What can I do. I don't want to be sent to collects. I am on a lien, and they are demanding payment. As I am closing my claim. I have multiple signatures from my other providers from my MVA that show my real signature.

What kind of lawyer do I hire?

Thank you.

 

[quincy]

What is the name of your state (only U.S. law)?
Washington State.

It's obvious that a doctor forged my signature on legal documents that state I would pay him/establishment in full. This signature they are stating is done on a computer. There are obviously differences in the signature that I will not go into detail about. Some obvious things are shapes letters are formed and what not. I always sign my middle initial, excetra.

The establishment is stating that since it was done on the computer electronically that it going to be altered. It is beyond altered and looks just like my practitioners handwriting.

What can I do. I don't want to be sent to collects. I am on a lien, and they are demanding payment. As I am closing my claim. I have multiple signatures from my other providers from my MVA that show my real signature.

What kind of lawyer do I hire?

Thank you.

DID you sign anything electronically for this doctor? Or are you saying you signed nothing?

And, in your earlier post, you say your chiropractor believed you were your own primary care. Primary care what? Doctor?

If your chiropractor believed you were your own primary care doctor, why would he believe this?


(Thank you for adding your questions to this thread, PleaseHelpMe. It is appreciated.)

 

[PleaseHelpMe111]

DID you sign anything electronically for this doctor? Or are you saying you signed nothing?

And, in your earlier post, you say your chiropractor believed you were your own primary care. Primary care what? Doctor?

If your chiropractor believed you were your own primary care doctor, why would he believe this?


(Thank you for adding your questions to this thread, PleaseHelpMe. It is appreciated.)

Hi Quincy,

I am saying that I did not sign anything at all or even remember the document. The document is a "Informed Consent for Care" form, with prices, and legal matters. I don't believe I'm legally require to sign anyways. The pdf signature is copied and payed even before I even came into the office. And I did conform that the doctors can alter the pdf and put in different signatures. I called the electronic intake form place and they say they never heard about a signature not looking like the normal or any alterations.

Is this a felony (forgery) and a violation of the HIPPA act?

The signature is not obviously not mine, and resembles that of my chiropractor.



Yes, when confronted about my concerns about my health management under his care for some reason my chiropractor said that I know health things. He was my primary care and referral doctor. I don't understand his statement, as I have no relations with the medical field. He did not listen to my injuries but was only interested in my opinion and feelings. He wrote complications were arising in my chart notes but did not state what or did anything about it, because I didn't know or say anything. I don't understand his mentality as I am not a trained doctor. He's suppose to do whats best for my injuries. Is this even legal? I mean, would he really take the risk of placing a patients care in there own hands?

Thank you!

 

[PleaseHelpMe111]

Term

Also I was in a second car accident and my old attorney never did mention________ term that I heard from another practitioner that I don't remember. It's were you have 2 cases and you split by a percent were the money from your treatment goes per case. What is that called? Its were you have 2 different injuries from 2 different cases and you have to distinguish how much money from treatment goes were.

Thank you.

 

[Zigner]

Your medical insurance should subrogate the amount against your vehicle insurance. I think you're making a mountain out of a molehill here.

ETA: I see that FlyingRon said this in post #2.

 

[PleaseHelpMe111]

Your medical insurance should subrogate the amount against your vehicle insurance. I think you're making a mountain out of a molehill here.

ETA: I see that FlyingRon said this in post #2.

I have government health care that does not cover the cost of anything but really emergency rooms visits and x-rays. Even if I did use my health insurance theirs a chance that my health insurance would want it paid back from the claim. It does not cover chiropractic or physical therapy.