Medical bills are an important building block for your slip and fall claim. Learn about using medical bills to get fair injury compensation.
Slip and fall accidents can grow costly as the medical bills keep rolling in.
You may have bills from an emergency room, follow-up doctor visits, tests such as CT scans and X-rays, and physical therapy.
Although billing from all of these sources can be confusing, injury victims have to know how to gather and organize their medical bills and receipts.
Your medical bills and out-of-pocket medical expenses add up to form the basis for your slip and fall settlement demand. You can use them to figure out your claim’s value and make certain that you receive fair compensation.
Let’s look into the topic of medical bills to make sure your claim is supported with a well built and secure foundation.
Gathering Your Slip and Fall Medical Bills
One of the first steps if you’re injured on another’s property is to seek medical attention. Even if an ambulance wasn’t called to the scene, you should go to your family doctor or a walk-in urgent care clinic as soon as possible.
By explaining the incident to your medical provider, including when, where, and how it happened, you create a record of how your injuries relate to the slip and fall accident.
You should continue seeking treatment until your medical provider tells you it’s no longer necessary.
At every stage of treatment for your injuries, you will be billed. These bills are some of the most important evidence in your slip and fall injury claim. Without that proof of a physical injury, your claim will likely fail.
It’s extremely important to gather all the bills and records from any medical provider who diagnosed or treated you for your slip and fall injuries.
Basic Medical Bill Management
If you’re handling your own claim, keep in mind that you’re responsible for collecting the medical bills and records to support your claim. You are not obligated to authorize the insurance adjuster to contact your medical care providers or to allow them to see personal health information not related to your injuries.
Be careful signing medical authorizations from the insurance adjuster.
Standard forms may allow the insurance company to get all your medical records for the last five or ten years. If you sign an authorization form, make sure it only covers treatment for your slip and fall injuries, and only from the accident date.
Make certain to get the complete billing for all of your treatments. This rule applies even if your health insurance covered some or all of your medical costs.
Insurance companies will try their best to reduce your compensation or avoid paying your claim altogether. A complete record of your medical bills helps ensure a fair settlement for your injuries.
To obtain all medical bills relating to your slip and fall injury, write down a list of all the medical treatment and assistance you’ve received. Think about the treatment from immediately after your injury and include all tests and treatment up to the present.
Gather bills from every provider on your list, including:
- Ambulance services
- Emergency room visits
- Hospital stays
- Physical or occupational therapy
- Chiropractic care
- Lab work and other diagnostic tests
Keep in mind that some medical services will generate more than one bill.
For instance, if you’re taken to the emergency room in an ambulance, you may receive a bill from the ambulance company, the hospital, and the treating physicians. The same goes for radiology appointments where you’ll receive one bill from the radiology department that took an x-ray and the radiologist who examined it.
In these scenarios, you’ll want to keep all of the bills in your file. You’ll also want to hold onto receipts for medication and other out-of-pocket expenses.
Make a Case File
To help manage your medical bills, it’s best to keep a well-organized file.
A file will make it easier to reference a bill during settlement negotiations with the insurance adjuster. A file also helps keep your paperwork and bills clean and legible, and prevents bills from getting lost.
Keep a file of every medical bill or statement from your medical providers and all pharmacy receipts. It helps to separate the bills by provider, then by date order, with the latest bill on top.
How to Get Copies
The best way to get your medical bills and records is to contact the doctor’s office where you were treated.
Typically, you can send a written request for your medical records. Most medical providers have a separate billing office, so you should send that office a written request for your bills.
When making this request, make sure to provide the following information:
- Your full name
- Date of birth
- Whether you want paper or digital copies
- Where to send the records
- The date range of the records or bills you need
As to date range, you may have received treatment from a doctor for years but are only looking for the records and bills about the treatment for your slip and fall injury. Including a date range helps prevent you from receiving stacks of paperwork unrelated to your accident.
It may help to request two copies of medical bills and records if the doctor’s office can do that. If not, be sure to make copies when organizing your file at home. Don’t write on or otherwise mark up the original bill or record.
When it comes time to hand over medical bills and records to the insurance adjuster, keep the original documents in your file and only give them copies.
Difference Between Medical Bills and Records
Medical bills show the breakdown of costs for the medical services you received and include information regarding insurance adjustments and payments.
On the other hand, medical records consist of all the information collected whenever you go to the doctor or hospital. This includes doctor’s notes, vital signs, lab tests, and results.
While you’ll likely provide both bills and records in your slip and fall claim, the bills relate more directly to your compensation. The medical records define the extent of your injuries, and help justify your medical treatment and time off work.
HIPAA Issues with Medical Bills
Medical records and bills are not difficult to obtain. It does take time, though, and certain federal and state laws affect who can access your records.
The federal Health Insurance Portability and Accountability Act (HIPAA) protects personal health information, including your medical records. HIPAA limits who can access and obtain your private information. It protects your privacy while also protecting your right to get copies of your own medical records.
HIPAA also allows each state to regulate access to medical records.
State regulations can affect:
- Copy fees charged for records
- The timeframe for your medical provider to release your records
- How long a medical provider has to store your records
Find your State Medical Records Laws here.
You can designate third parties to receive your personal health information by signing a HIPAA authorization form. This allows the doctor’s office to release your medical records to someone other than you, like your spouse, your attorney, or the insurance company.
Authorizations allowing third-parties access to your records can be revoked at any time, but the revocation must be in writing.
Don’t Short-Change Your Slip and Fall Claim
Your medical bills are the starting point to add up your injuries in terms of dollars. Supporting your claim with complete medical bills can help you get full and fair compensation.
When you add up your medical bills to determine your claim’s value, include the full value, not just the portion of the bill you had to pay.
If your health insurance covers some or all of your medical bills, you should still claim the full amount. The full amount means that when you’re adding things up, focus on the total cost billed. This is the amount of a service before health insurance copays, deductibles, or offsets from your health insurance, Medicare, or Medicaid.
Example of a Bill with a Copay
John is taken to the emergency room by ambulance after a slip and fall accident.
In time, he gets billed $900 by the ambulance company and $2,000 by the emergency department at the hospital.
John has a health insurance policy covering both of these costs, but he has a $90 copay for the emergency department services. The copay means John has to pay $90 for the ER care after paying his deductible.
When he totals his bills, John includes the $2,000 bill and the full $900 bill in his injury claim.
He doesn’t include the $90 copay or any deductible because it’s already included in the total amount billed.
Watch out for Medical Liens
It’s important to calculate your demand based on the total amount billed. This is especially true if you have medical liens.
A lienholder is an individual or organization to whom you legally owe part of your settlement compensation.
Private health insurance, Medicare, Medicaid, the Veterans Administration, and others who cover your treatment cost can sometimes hold a lien against any injury settlement to recover what they paid out on your behalf.
After you receive compensation for your slip and fall injuries, you may be required to pay that lien. This process is known as “subrogation.” The subrogation process will depend on your health insurance policy and your state laws.
If you don’t have health insurance, the hospital or treating physicians may file a lien against a potential injury settlement to recover any portion of the medical bills you still owe.
When adding up your bills, again focus on the total amount billed. If you only include payments made here and there, then you run the risk of short-changing yourself by accepting less compensation than you need to cover your medical liens and personal needs.
Tackle any potential medical liens before settling your claim. Good communication can go a long way in your negotiations with lien holders. If you don’t have health insurance, they would rather get a reduced amount to pay off the lien than end up with nothing if you can’t settle your injury claim.
Personal injury attorneys can help with liens. They have experience negotiating lien amounts and might settle the lien for less than the total amount owed. The outcome means more of the settlement goes to you.
Beware of “Accident Doctors” Running up Big Bills
While insurance companies use medical bills to calculate the value of slip and fall claims, they only have to pay reasonable expenses.
Watch out, therefore, for “accident doctors” who charge you for unnecessary tests or treatments. You could end up having to pay these bills out of your own pocket if the insurance company refuses to pay for them.
You can always get a second opinion if a doctor recommends questionable and expensive treatment.
Compensation for Other Damages
Medical bills are the most important basis of your slip and fall injury claim, but the insurance company will consider other economic losses related to your injury.
To prove an economic loss is directly related to your injury, you’ll need to provide documentation in the form of bills and receipts.
In addition to medical bills, this documentation can include statements to prove lost earnings if you miss work because of your injury.
You’re entitled to reimbursement for out-of-pocket expenses, such as medication, gasoline, parking when visiting the doctor, and other costs resulting from your injury. You can also estimate future out-of-pocket expenses if you are still suffering from your injuries.
Be sure to keep all these bills, receipts, and other documentation in your organized claim file.
You can also seek compensation for non-economic losses, such as pain and suffering, emotional distress, loss of enjoyment, and loss of consortium. There will be no bills or receipts for such losses.
Because you won’t have bills and receipts to put an exact dollar amount on non-economic losses, it’s important to keep some record of the pain, discomfort, psychological distress, and loss of enjoyment in your everyday life that is caused by your slip and fall injury and treatment.
You can keep a journal to show your level of pain and suffering following your accident or track any difficulties with daily tasks.
Get Help to Maximize Your Compensation
Slip and fall injuries can be traumatic. Injuries and treatment are often emotionally or physically draining, and their cost may cause financial stress.
Many injury claims involve bumps, bruises, muscle or tendon sprains or strains, and minor cuts. If you’ve recovered from such injuries with treatment and rest, you may decide you can handle your own claim.
If the injury is more severe or you received extensive treatment from numerous providers, it can get complicated when trying to add up all your losses.
If you aren’t sure of the true value of your claim, it helps to talk to an attorney. Attorneys are expert negotiators with years of experience, specifically with injury claim negotiations.
If you decide to hire an attorney, they will help you obtain medical bills and records so long as you give them written permission to do so.
Your lawyer will know:
- What bills are critical to collecting reimbursement for expenses
- How to get the bills and records as quickly as possible
If a lawyer helps collect your bills, it’s still a good idea to keep your own injury file. There are times when you may have to refer to a bill when dealing with another person or business. Having your own file will help ensure you have a copy of the bill close by.
Most injury lawyers work on a contingency fee basis. That means if they can’t settle your claim, you don’t owe them anything. If they negotiate a settlement or get a court award for you, they’ll receive an already determined percentage of your compensation.
Further, since most injury attorneys provide free consultations, it won’t cost you a penny to better understand your legal options. Find out how an attorney can help you today.
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