User Tag List

+ Reply to Thread
Results 1 to 5 of 5

Thread: Medical Billing, Insurance Write-offs and the Collateral Source Rule

  1. #1

    tPF Moderator
    Points: 40,611, Level: 49
    Level completed: 28%, Points required for next Level: 1,239
    Overall activity: 99.2%
    Achievements:
    Recommendation Second ClassSocial50000 Experience PointsTagger First Class1 year registered
    DGUtley's Avatar tPF Moderator
    Karma
    163824
    Join Date
    Jul 2016
    Location
    Northeast Ohio
    Posts
    10,918
    Points
    40,611
    Level
    49
    Thanks Given
    4,189
    Thanked 9,086x in 5,241 Posts
    Mentioned
    349 Post(s)
    Tagged
    0 Thread(s)

    Medical Billing, Insurance Write-offs and the Collateral Source Rule

    Medical Billing, Insurance Write-Offs and the Collateral Source Rule

    This has become a monster issue in personal injury litigation. Here's how it works:

    Mr. Jones is injured in an accident but has a great recovery. His medical bills are: Billed: $136,000 but b/c of the insurance contractual-adjustment provisions, the providers accept $21,000 for the medical charges in complete satisfaction. What is his element of damages? Nobody has paid the $115,000 that's been eliminated. In Ohio, I'm allowed to introduce the lower amount as 'evidence of the value of the services rendered' according to the OHSC. This is important b/c emotional distress / pain and suffering is generally limited to 3x's economic loss, creating quite a difference.

    This article discusses this issue.
    Any time you give a man something he doesn't earn, you cheapen him. Our kids earn what they get, and that includes respect. -- Woody Hayes​

  2. #2
    Points: 5,766, Level: 18
    Level completed: 3%, Points required for next Level: 584
    Overall activity: 36.0%
    Achievements:
    3 months registered5000 Experience Points
    Kacper's Avatar Senior Member
    Karma
    1027
    Join Date
    Aug 2017
    Posts
    2,404
    Points
    5,766
    Level
    18
    Thanks Given
    495
    Thanked 1,017x in 747 Posts
    Mentioned
    9 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by DGUtley View Post
    Medical Billing, Insurance Write-Offs and the Collateral Source Rule

    This has become a monster issue in personal injury litigation. Here's how it works:

    Mr. Jones is injured in an accident but has a great recovery. His medical bills are: Billed: $136,000 but b/c of the insurance contractual-adjustment provisions, the providers accept $21,000 for the medical charges in complete satisfaction. What is his element of damages? Nobody has paid the $115,000 that's been eliminated. In Ohio, I'm allowed to introduce the lower amount as 'evidence of the value of the services rendered' according to the OHSC. This is important b/c emotional distress / pain and suffering is generally limited to 3x's economic loss, creating quite a difference.

    This article discusses this issue.
    You left off a link to an article.

    A lot of medical providers in our area won't bill health insurance if it is related to an automobile accident because they don't want to take the write-offs even though they allege it is due to subrogation issues. It gets more complicated on the other side because some liability companies increasingly offer such low settlements that they now have their own law firms (as they own the law firm) to represent them they are in litigation so much (Yes I'm talking about you GEICO and Nationwide) because they don't even offer enough to cover damages and legal fees outside litigation. "Not our fault your client hired a lawyer" and "Not our fault your client doesn't have other insurances to mitigate his losses" are frequent refrains from them.

  3. #3

    tPF Moderator
    Points: 40,611, Level: 49
    Level completed: 28%, Points required for next Level: 1,239
    Overall activity: 99.2%
    Achievements:
    Recommendation Second ClassSocial50000 Experience PointsTagger First Class1 year registered
    DGUtley's Avatar tPF Moderator
    Karma
    163824
    Join Date
    Jul 2016
    Location
    Northeast Ohio
    Posts
    10,918
    Points
    40,611
    Level
    49
    Thanks Given
    4,189
    Thanked 9,086x in 5,241 Posts
    Mentioned
    349 Post(s)
    Tagged
    0 Thread(s)
    It's there -- click it. "medical billing..." will click.
    Any time you give a man something he doesn't earn, you cheapen him. Our kids earn what they get, and that includes respect. -- Woody Hayes​

  4. The Following User Says Thank You to DGUtley For This Useful Post:

    Peter1469 (01-13-2018)

  5. #4

    tPF Moderator
    Points: 256,538, Level: 100
    Level completed: 0%, Points required for next Level: 0
    Overall activity: 99.5%
    Achievements:
    SocialVeteran50000 Experience PointsOverdrive
    Common's Avatar tPF Moderator
    Karma
    323564
    Join Date
    Feb 2013
    Posts
    45,380
    Points
    256,538
    Level
    100
    Thanks Given
    1,208
    Thanked 2,766x in 1,658 Posts
    Mentioned
    55 Post(s)
    Tagged
    0 Thread(s)
    Another point to be made is that if you dont have insurance they will bill the entire amount and not accept less, thats just absurd
    Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies.

    GROUCHO MARX,

  6. #5
    Original Ranter
    Points: 456,542, Level: 100
    Level completed: 0%, Points required for next Level: 0
    Overall activity: 73.0%
    Achievements:
    SocialCreated Album picturesOverdrive50000 Experience PointsVeteran
    Awards:
    Posting Award
    Peter1469's Avatar Advisor
    Karma
    411521
    Join Date
    Jun 2011
    Location
    NOVA
    Posts
    140,018
    Points
    456,542
    Level
    100
    Thanks Given
    80,586
    Thanked 62,491x in 42,743 Posts
    Mentioned
    2141 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by Common View Post
    Another point to be made is that if you dont have insurance they will bill the entire amount and not accept less, thats just absurd
    They accept less from insurers because they have long term business relationships.
    Alea iacta est

    Check out the blog.


+ Reply to Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts


Critical Acclaim
Single Sign On provided by vBSSO