Why Would a Medical Provider Not Bill My Health Insurance?
- First, a medical provider may not be obligated to bill your health insurance
- Second, a medical provider may receive more money from you if they refrain from billing your health insurance and claim a medical or physician lien
While this may be surprising, consider what the medical provider will likely receive from the Division of Medical Assistance (Medicaid) as payment for services rendered on a $1,000.00 bill. The answer is rather surprising. Depending on the provider, Medicaid may pay a few hundred dollars at most on their $1,000.00 bill, the reason being that Medicaid has negotiated significant cuts with the medical providers to keep costs low.
On the flip side, a medical provider who refrains from billing Medicaid and receiving a significant cut to their $1,000.00 bill can claim a medical lien and seek reimbursement for the entire $1,000.00 bill. While no one wants to pay more for the same treatment, being able to claim $1,000.00 in damages as opposed to a few hundred dollars may actually be more beneficial to your claim for damages.
However, this does not mean that you should refuse to use your health insurance. Most insurance companies will refrain or delay settlement negotiations with an accident victim until it has been determined whether the victim has health insurance or not. Even if you do not, the insurance company may request that you sign an affidavit of no health insurance. An affidavit of no health insurance is a sworn statement by an accident victim attesting to the fact that they have no health insurance.
How Long Is Too Long After the Accident to See a Doctor?
Generally, in any accident claim involving an individual who has not received some kind of medical treatment within the first 7 to 10 days, it will be difficult to make a strong claim and/or prove damages. However, even in those instances where you may feel you do not need emergency medical care, you should still call your primary care physician and make an appointment. If you have called your primary care physician and your appointment is longer than two weeks away, you should seriously consider visiting urgent care or finding another available primary care physician for an earlier appointment.
This general rule does not mean that you should forego or refrain from seeking medical treatment if you are unable to receive medical care within the first 7 to 10 days after an accident. There are many exceptions to and factors that affect this general rule.