The do’s and don’ts of medical billing in a disputed Michigan workers compensation case.
There is a running joke among plaintiff attorneys regarding unpaid medical bills. We are essentially debt collectors who don’t get paid anything for our time.
Medical providers should be happy to hear from our office. It means a settlement is close and we are trying to resolve unpaid medical bills.
Michigan law requires medical providers to accept payment based upon a fee schedule. This is known as “cost containment” and all charges must be submitted on a proper claim form.
Do provide all medical bills on either a CMS 1500 or UB-92 claim form. This is required to calculate the amount that is owed under cost containment.
Don’t provide an itemization and expect to be paid. Most insurance companies will ignore medical bills unless properly formatted.
Do send unpaid bills to the attorney representing the patient. Nothing is more frustrating than trying to get a medical provider paid without knowing the outstanding balance.
Don’t charge excessive fees to process claim forms. The attorney is trying to get medical bills paid and unnecessary charges end up costing the patient.
Do file a lien with the Agency to protect interests. A magistrate will not typically approve a settlement unless liens are resolved.
Don’t send patients to collections. This causes stress for the patient and typically results in less money being paid. Collectors are willing to give attorneys steep discounts to make a commission.
Do follow-up with the attorney every couple months. Our office will tell you when a matter is going to resolve and when payment should be expected.
Don’t sue the patient in district court. This is not the proper venue and we ask for costs and attorney fees.
Do accept a reasonable reduction in the total bill. Getting payment directly from the settlement is a much better option than chasing the patient for every dollar owed.
Don’t expect full payment without a reduction for cost containment. Negotiating with the attorney is the best way to ensure payment.
Do submit disputed medical bills to health insurance. This will ensure payment and the health insurance company will subrogate the claim in workers compensation.
Don’t wait to submit medical bills to other insurance. Insurance companies have time limits to submit claims and waiting could jeopardize the patient’s legal rights.
Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (855) 221-2667 for a free consultation today.
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Photo courtesy of Creative Commons, by Kevin Spencer.