What to Do If Your Medical Bills Are More Than Your Settlement: When you suffer from an injury caused by the actions of another individual, and you ultimately receive a settlement, you may feel a sense of relief. After all, you reasonably expect that these funds will be enough to address and compensate for your medical care, missed work, and the overall emotional harm caused by the experience. What happens, however, when there are additional medical expenses incurred and the total is more than the settlement amount you received?
Unfortunately, you are not alone if you find yourself in this situation. Many cannot believe how devastating it can feel when you realize, after the fact, that your settlement does not even come close to addressing your accumulated medical expenses. The encouraging news is that you always have the ability to do a few things to reduce your bills, protect your finances, and avoid catastrophic medical debt.
Table of Contents
Why Medical Expenses May Exceed the Settlement
1. Policy Limits
The amount of your settlement is often limited by the at-fault party’s insurance coverage. If your assailant only has minimum liability insurance, you may receive a settlement amount that will not cover even one trip to the emergency room, let alone future therapy treatments or ongoing care.
2. Multiple Providers and Hidden Expenses
When you receive medical treatment for an injury caused by an accident, you are likely to receive expenses from several different providers, including the hospital, treating physician, imaging center, laboratory, and specialists, to name a few.
3. Hospital “Chargemaster” Rates
The differences between the costs hospitals charge uninsured or self-pay patients isn’t worth overlooking. Hospitals may charge uninsured patients far more than insurance is billed. In your instance, you might have been charged the inflated “chargemaster” costs if you were uninsured or it was determined your case was pending.
4. Future and Unexpected Treatments
It is possible to settle your case before medical care has completely finished. If you were to require future medical intervention such as physical therapy, surgery, or follow-up appointments that exceed your settlement.
5. Medical Liens
Medical providers or health insurers can initiate a lien against your settlement, meaning they will get paid before you do. This can greatly reduce the money you take home when the case resolves.
Steps to Take When Your Medical Bills Exceed Your Settlement
1. Understand What You Owe
Your first step is to ask for all of your medical bills in the case. Make sure all of the charges are accurate, itemized, and related to the treatment of your accident. Being organized here will give you the foundation you need for the next step.
2. Check for Errors, Duplicity, and Enumeration
Errors occur often in medical billing. Charges can be duplicated, miscoded, or inaccurately charged. Ask for itemized statements and question anything you do not understand or think is incorrect.
3. Ask for a Payment Plan
If you’re unable to pay the entire balance right away, request a long-term payment plan with no or low interest. Many hospitals and clinics have flexible plans that can make a big amount broken down into smaller sums for periods of time.
4. Research Financial Assistance or Charity Care
Nonprofit hospitals must provide financial assistance, and even if you received treatment already, you may now qualify for retroactive assistance that will significantly reduce your bill.
5. Look into Establishments and Other Options
Review your insurance to see if you have secondary coverage (life underinsured coverage, MedPay, or Personal Injury Protection PIP), as often these coverages can fill some gaps that might exist from the settlements and medical bills.
6. Pay Strategically
If you have more than one provider, begin the payment process based on urgency. Pay medical liens, collections accounts and then pay everyone else, particularly those who will negotiate. An experienced attorney and/or billing service can help structure the payments and get the most out of what is owed to the different providers.
Consider Professional Help
If all the numbers get overwhelming, a professional, such as a billing service or financial advocate can get you money, save you time and money, and save you stress in the process. They will arrange the arrangements for you, confirm charges, and make sure bills are done correctly. If you can’t pay the full amount right away, request a long-term payment plan with no or low interest. Many hospitals and clinics offer flexible arrangements that make large balances more manageable over time.
The Role of TueCa RCM™, LLC
This is where TueCa RCM™, LLC becomes your trusted partner. TueCa RCM™ is a professional medical billing company focused on assisting patients and healthcare providers with the complicated medical billing issues resulting from personal injury settlements. TueCa RCM™, LLC can provide you with:
- Thorough Bill Auditing: TueCa RCM™ audits all medical bills for accuracy, spotting duplicate or unrelated charges that increase your balance.
- Negotiating Power: We will negotiate directly with your healthcare providers to reduce your medical bills at the time of settlement and can work to set up payment plans for you after your settlement, if needed.
- Aspects of Settling with Liens: TueCa RCM™ will account for any Medicare, Medicaid, or other hospital/physician liens and will direct the settlement funds by paying all appropriate parties on your behalf.
- Open to the Process & Reporting: TueCa RCM™ gives you simple reporting, so you will always know what payments have been made, what was reduced, and what is left outstanding.
By working with a billing service like TueCa RCM™, you can focus more on healing and recovering from the accident without worrying as much about incorrect medical bills or billing disputes. We handle the complicated billing process, ensuring that you don’t pay more than you need to and every dollar from your settlement is managed efficiently.
How to Prevent This Situation in the Future
- Don’t Settle Too Early: It is important to wait until your treatment has concluded, or until you have a good idea of the prognosis, before accepting any settlement. Settling too early may mean that you are neglecting future medical costs.
- Understand Insurance Plan Limits: Before you agree to a settlement, you want to know how much coverage is available from all insurance companies providing coverage.
- Document Every Expense: Keep a copy of every bill, report, and payment. This will help you to be able to verify later if anything is wrong on the billing side of things, or with providing more collateral.
- Hire a Personal Injury Attorney: If you have a skilled attorney, they can negotiate for larger settlements and help you work with your providers and liens.
- Hire a Billing Expert Early: By engaging a medical billing company early in the process, you will avoid many of the pitfalls that an injured person can encounter and you are able to document accurately from day one.
Wrap-up Thoughts
When you realize that your medical bills are higher than your settlement, it may feel like getting punched in the gut, but it’s not the end of the world. With the right mindset, strong negotiations, and help from professionals such as TueCa RCM™, LLC, you will be able to be back in the driver’s seat and will be much closer to protecting your peace of mind.
Remember: you never have to feel powerless. Many people have successfully reduced their medical bills, received payment assistance, and moved forward. With some organized diligence and help from professionals, you will be able to too.
Frequently Asked Questions:
Question 1. Why is it possible for my medical bills to exceed my settlement amount?
Answer. Settlements are generally restricted by insurance policy caps and there may have been some future or uncovered medical costs associated with your injuries. Total bills often exceed your payout.
Question 2. Can I negotiate with my medical providers after I receive my settlement?
Answer. Yes. Most medical providers will be willing to negotiate your bills down or structure a plan once they get the picture that the settlement is limited and your financial situation is bad.
Question 3. What happens if I cannot pay the remaining balance due to medical bills?
Answer. You can always request financial assistance, you may be able to negotiate a reduced payoff, and other debt relief strategies to help you avoid damage to your credit or collections.
Question 4. How can TueCa RCM™, LLC be of assistance to me?
Answer. TueCa RCM™ reviews, negotiates and manages your medical bills to ensure the charges are accurate, balances are reduced, and dollars from your settlement are properly allocated, so you keep more of your settlement!
Question 5. Should I hire a billing company if I already have an attorney helping me?
Answer. Yes. A billing company does one thing and one thing only: set the accounts up and manage your financial situation. Your attorney is primarily managing your case and all the legal aspects of your case. A billing representative is focused solely on accuracy concerning medical billing and would not allow anything to fall through the cracks.
