Illegal Hospital Billing: Know Your Rights

This illegal hospital billing scenario is playing out all over Colorado right now: Victims of auto accidents and motorcycle accidents are entering emergency rooms and trying to supply the hospital with their health insurance information to cover their bills. Hospitals are saying (in a nutshell): “Oh, you shouldn’t have to pay for this. You were the victim. Give us the other driver’s insurance information and we will bill them instead.”

Sounds so nice, right? But hospitals can’t do anything with the other driver’s insurance. Nothing. Nada.

Why illegal hospital billing happens

Here’s what they’re really doing: They are avoiding billing until the victims settle their lawsuits and the hospitals then get their fees paid out of the settlement. It’s complicated, but here’s why they are doing this:

• Hospitals have agreements with health insurance providers that allow them to be paid only a percentage of a full bill, usually .50 or .60 cents on the dollar.
• Hospitals are instead trying to forego billing and then they put a lien on any settlement that the victim receives as a result of the accident.
• Through the lien, the hospital is trying to get the full bill paid. However, this ends up costing victims a lot more, and victims usually need every dime from a settlement to address ongoing issues as a result of the accident (loss of job, loss of home, other bills).
• Essentially, the hospitals are refusing to bill the victim’s health insurance and are instead billing the victim.
• Even worse, if the victim receives no compensation for the accident (if, for example the at-fault driver had no insurance), the victim may be forced to pay medical bills that medical insurance would have covered.

There are many things about this practice that get my dander up, but here’s one of them: IT’S ILLEGAL FOR THEM TO DO THIS! As a result of Senate Bill 15-265, hospitals must bill a victim’s health insurance upon providing service. This bill came about because so many victims were being re-victimized by predatory hospital practices.

If you are the victim of an accident and you end up in the emergency room, make sure you provide the hospital with YOUR insurance and tell them specifically: “You must bill my health insurance company for the care that you provide to me.” Make sure you give them a copy of your health insurance card.

This is just one more example of why accident victims need a good accident attorney. Most victims have no idea how to negotiate these treacherous waters and they may have no idea that their hospital bills aren’t even being paid! I’ve seen people whose credit scores have plummeted because they had no idea until too late that hospitals were toying with their payment processes.

If you have any questions at all, or if you’ve been in a recent accident and have question about the billing process, please contact us: 303-388-5304.