Fort Worth Injury Attorney Blog

The statute lists various requirements that must be strictly followed. These are some of the common errors made:

• The required information is omitted;
• The patient is admitted after the allowable time;
• The facility does not file the hospital lien with the correct county clerk or at all;
• The hospital charges too much;
• The medical treatment is for too long of a period of time; and/or
• The hospital accepts partial payment.

Is there a limit to the amount covered by the lien?

Yes, the amount must be reasonable for necessary services to treat a serious medical problem. However, proving these criteria can be difficult. Fortunately, thanks to a new law that took effect on January 1st, a personal injury lawyer can use cost estimates that the hospital is required to post on its website. For example, a hospital charged $3,400 for each of the four CT scans performed, but its site says that the test should only cost $675, so this saved our client a large amount of money. The attorney can also research what other local hospitals charge for the same services. Further, the total medical bill cannot exceed more than 50% of all amounts received by the injured person. For example, if the victim receives the negligent driver's total insurance policy of $30,000 and the hospital bill is $20,000, it must reduce the amount below $15,000. However, that is still an enormous amount, so the cap is often ineffective at making sure the patient is fairly compensated. In addition, the hospital is required to bill the patient's health insurance company, Medicare, or Medicaid plans within (1) the date on any applicable contract or (2) at the latest, by the first day of the 11th month after the injury. If the hospital partially collects on the patient's health insurance policy, it is barred from further payment from the patient. A new law will prevent surprise bills.

Can only the first hospital file a lien?

No, a lien can also be filed by providers including the

• ambulance company in smaller counties with populations less than 800,000;
• emergency room physicians if the reasonable cost of the services is less than $1,000; and
• if the victim is transferred to another hospital, the lien also protects the second facility.

Are all insurance policies covered?

It is usually necessary to have a personal injury attorney resolve this expensive issue. That is because until the lien is released, insurance companies will insist that the name of the hospital appear on the settlement check so it gets paid in full.

After you are in a car, truck, or 18-wheeler wreck, you will need medical treatment so you can heal. But it is expensive and you may not know how to get your medical bills paid. You naturally assume that the other driver and their insurance company are going to pay them quickly. But it can take some time for the possible payers -- the other driver's automobile insurance, your health insurance, your car insurance, and others -- to decide if they are going to pay you. Then they have to look at the medical records and medical bills and decide how much they want to pay. This is often a slow, complicated, and unfair process that affects every car and truck collision. Unfortunately injured people need to wait to negotiate a settlement or obtain a jury verdict until the possible payers obtain this information:

• what their injuries are,
• whether he or she needs surgery,
• how much their medical bills and lost wages are,
• how much pain they have and will experience, and
• if they have suffered other damages.

This can take months to determine. But in the meantime, medical bills and then threatening FINAL NOTICE letters arrive. There is often a conflict between the injured person physically recovering from their injuries and not being harassed by bill collectors. What is the solution? In our last post we discussed some ways you can have your hospital, doctor, and other expenses paid after you were injured in a car or truck crash in Texas. This is such an important topic that we wanted to give you more useful ideas.

More resources to get your medical bills paid or deferred

You need to know up-front that this process is not easy. There is no one-size-fits-all solution and more than one source of funds is usually needed. You will have access to some of the following resources but not others.

Start with your job benefits: 

1. Short and long-term disability plans

Some companies offer to pay their employees two-thirds of their weekly wages and many of their medical bills if they cannot perform their job duties.

2. Unemployment benefits

If you lose your job, you should file for compensation through the Texas Workforce Commission.

3. Workers compensation or in-house plans

If the car or truck crash happened while you were driving while performing a job duty, for example while making a delivery, your company often has an insurance policy or similar program that will pay some of your medical bills and lost wages.

See if you qualify for any government programs:

4. Medicare 

5. Medicaid

Depending on your age and income status, these federal and state reimbursement programs can help get your medical bills paid. Note: repayment is often required

Note that the above programs and plans have liens which means that their payments must be repaid. But here's some good news: the amounts they pay are greatly discounted. For example, if a hospital bill with X-rays and CT scans totals $5,000, they might pay $500 to $1,500 and the balance is written off. And our office is often successful in reducing the remaining amount which can save thousands of dollars.

Use other solutions:

6. Letters of protection

Your accident lawyer can arrange delayed payments with certain medical providers. The advantage is that you do not have to pay your doctors out of your own funds until the settlement check arrives. At that time, they can often reduce those medical bills, again saving you a lot of money.

7. Installment agreements

Almost every hospital or doctor will allow the patient to make small payments while their case is pending. We always recommend that our clients pay even $10 a month so the provider know that it will get paid later. That way you can continue to receive treatment and your credit is not hurt.

8. Hardship arrangements

Some facilities will allow the patient to pay a reduced cash amount and they will write off the balance.

9.  Loans

We strongly advise our clients not to apply for the super high interest loans you see advertised on television and on the internet. In emergency cases, our office will make zero percent (0%) interest loans to our clients to pay medical or living expenses.

10. Complaints about medical billing

Calling or writing the medical provider if you believe that you have been overcharged or the services were inadequate may assist you. The Texas Department of Insurance has some useful resources including

• mediation,
• complaints, and
• reimbursement rates information.

The Texas Department of State Health and the Texas Medical Board also investigate complaints against hospital and doctor for over billing. A good car accident lawyer will help you put together the pieces of your jigsaw puzzle. Mr. Berenson is one of the top-rated personal injury attorneys in North Texas. He only represents people who have been injured in car, truck, and 18-wheeler collisions. Contact him if you have any questions about your injury claim.

How much will your medical bills probably cost after a Texas car accident?

A lot! Total costs for your medical bills could cost as much as $10,000 and possibly more. If surgery is required, expenses can exceed $50,000,  even $100,000. And a catastrophic injury can cost over $1 million.

So as you can see, this is a very important topic. The problem is that you will not know in advance which doctors you need to see, what they charge, and who is paying them. That is the reason that the statute of limitations in Texas is two years from the date of the collision. Lawmakers knew how long this process can take and gave injured Texans two years to treat and then negotiate their insurance claim or file a lawsuit.

How to get your medical bills paid before the settlement or jury verdict

You might assume that State Farm, GEICO, or the insurance company the negligent driver is covered by will automatically mail you reimbursement checks. Unfortunately, this never happens. Why not? Insurance companies, like businesses, do everything they can to maximize their profits. They do this in two ways: raising premiums and lowering the money they pay in claims.

That is why the company often denies fault and minimizes damages. It does not want to pay much, if any, money until an aggressive personal injury lawyer makes them. How much should the insurance company pay if it assumes liability and decides to make an offer? You can't get an accurate answer from the internet, a friend, or a lawyer commercial on TV. Without the expert help of an experienced personal injury lawyer, you are not be in a position to know how much a car accident case is worth.

Ways to get your medical bills paid before the settlement or jury verdict

5. Underinsured motorists

Underinsured motorists coverage can be filed on if the bad driver only had the minimum policy of $30,000 per person and your damages are clearly much higher than that. For example, you had to have surgery, your medical bills were $50,000, and you lost wages of $5,000.

Takeaway: the other insurance company does not have to reimburse you for your medical bills up front and will try to underpay you later.

We can help you

If you have suffered from personal injuries caused by another driver in Fort Worth, Dallas, or anywhere in North Texas, you should also seek the assistance of an experienced lawyer. The personal injury claims process is complicated and trying to handle the claim or lawsuit yourself can cost thousands of dollars. We will guide you through the snake-like process. Among other steps we take, we will

• obtain the police report and speak to the officer,
• investigate how the collision happened,
• get statements from eyewitnesses,
• secure photographs and other evidence,
• prove liability,
• work with you and your doctors to get the medical treatment you need so you heal as quickly as possible,
• make sure their payment is made or secured,
• document your injuries and medical bills so you can be fairly compensated, and
• negotiate a favorable out-of-court settlement or file a lawsuit.

For over 40 years, Berenson Injury Law has successfully represented injured Texans. The only way an insurance company will ever pay someone a reasonable amount of money is if it believes that the injury attorney can convince a judge and jury to award a large verdict. Our experienced team of professionals will help you figure out your best strategy. We tailor a plan to meet the individual needs of every client.

Please let us know how we can help you by calling us at 817-885-8000 (toll-free at 1-888-801-8585) or by filling out this contact form.

For more information please read:

How can a personal injury attorney obtain medical records and costs?

After a car crash or other tortious act, the lawyer must obtain the victim's medical records and calculate their bills to prevail in their lawsuit or insurance claim. Unfortunately the process to obtain medical records can be expensive and slow and the ability to learn medical costs has been nonexistent. But these should not be road blocks that delay litigation and hobble insurance claims in our high-speed digital world. So it is good news to both plaintiff lawyers and their clients that the federal government has adopted two important remedies to fix these problems.

1. New medical records rule

• Deadlines for healthcare providers to deliver electronic records to patients are shortened to 15 days, half of the 30 days now allowed;
• Records must be delivered to injured people who request their records online free of charge; and
• Patients can request that records also be sent to their attorney.

How to get medical records efficiently

In 2009, as part of the Recovery Act to counteract the Great Recession, Congress enacted the HITECH Act. It substantially expanded and required electronic health information use in the medical industry. One commentator called it "HIPAA on steroids." That aging privacy law and medical records delivery system enacted in 1996 was rarely enforced and if so, penalties were minor. One of its best features of HITECH was the patient's ability to to obtain records for only $6.50 per record-set plus postage and the labor cost of the provider, not the costs of outsourced providers including HealthPort and Ciox. Costs may increase if the records are recorded on paper. This fee superseded any state law that allowed higher amounts. This was critical since enormous mark-ups are the norm. Records regarding a hospitalization with surgery can cost over $1,000, and more with required affidavits. HITECH allowed an individual to obtain their electronic medical records within 30 days by using a simple request. He or she could also direct that they be sent to their attorney or other party. Practice tips: 1. Only the individual, not an attorney, can make the HITECH request. The letter should simply designate who the recipient of the records is and be signed by the individual. 2. He or she must pay for the records. 3. The individual can designate their attorney to receive the records. 4. If the individual has deceased or is incompetent, a personal representative may sign the request of their behalf. 5. However, the attorney is allowed to fax the letter from their office on the client's behalf and can write a follow-up letter notifying the provider that it has violated HIPAA regulations and that he or she intends to file a complaint with the Department of Health and Human Services. 6. A HIPAA third-party authorization is not required. 7. All records, including x-rays, CT scans, MRIs, film and CDs, bills, and audit rails, must be produced. The only exception is for psychiatric notes taken during a counseling session and documents prepared for litigation or quality control. 8. If the responding provider/records custodian does not reply, file a complaint filed with the Office of Civil Rights at HHS. See www.hhs.gov/ocr/complaints/index.html 9. Sometimes, this process is not as easy as it should be. More information about this process and how to meet objections from the records providers is here.

The decision that caused the new rule

The new rule undoes the damage to plaintiffs caused by a lawsuit filed by a national medical records provider which claimed that HITECH caused it to lose a substantial amount of money. A federal judge on the D.C. Circuit ruled in January 2020 that third parties -- especially law firms -- could no longer obtain those records inexpensively and made other decisions that reduced the simplicity and cost-savings of HITECH.

Huge penalties can be assessed

The U.S. Department of Health and Human Services has actively enforced patients' rights to obtain their records cheaply and quickly. Each violation can be penalized with a fine up to $1 million.

2. New medical costs rule

Effective January 1, 2021 the Price Transparency Rule requires all U.S. hospitals to publicize 300 of their standard charges on their websites. This must be in an easily readable and searchable format to enable patients to make intelligent decisions about the cost of upcoming operations, diagnostic tests, and treatment. For example, one of the largest hospital chains in Texas has disclosed for the first time that a magnetic resonance image to the cervical spine will cost $958.19 (without health insurance, Medicare, or Medicaid). This is useful information.

What lies ahead?

The process of obtaining medical records and calculating the reasonable cost of medical bills will continue to be one of the thorniest aspects of a personal injury lawsuit. The battle will continue. For example, a new bill has been pre-filed in the Texas Legislature that convenes tomorrow to further reduce the amount of medical bills that can be allowed as "paid or incurred." Stay tuned.

Accident victims got some unexpected good news yesterday. A sweeping new law that will prevent most surprise medical bills was approved by Congress as part of pandemic-related legislation. The bill now moves to the President for approval. Bravo!

This has been a serious problem for many years. One of the biggest problems injured victims face comes weeks or even months later when they open their mail and find enormous surprise medical bills. This often happens because they have been treated by a hospital or doctor outside of their health insurance network so their company paid little, if any, money.

Of course, rarely. if ever. do people in emergency situations like car wrecks know in advance which providers will be paid.

This has resulted in an abusive practice called balance billing.

Further, victims have no idea that the hospital can charge any amount of money it wants to. We often see hospital bills exceeding ten thousand dollars due to treatment by multiple physicians and extensive diagnostic testing, not to mention huge costs for surgeries.

On the other hand, if the bills are in-network, there is no balance due, other that the co-pay and deductible. Further adding to the financial stress, someone often has a health insurance plan but it claims that it is secondary and refuses to pay. In other casers, it eventually pays after a long delay, but then demands to be repaid in a process called subrogation. To make matters worse, the at-fault driver's liability company has no legal duty to pay the plaintiff's medical bills up front, so it doesn't pay until it knows all of the damages the injured victim has suffered and how much money they are demanding for compensation. Surprise medical bills are a huge problem, especially in Texas where they are generated at two times the national average. The new law will help hundreds of thousands of Americans every year. Unfortunately, it does not take effect until January 1, 2022. So after the surprise car crash and surprise medical treatment, the surprise medical bills will surprisingly be allowed to continue for a long time.

Last summer our client injured his foot at a recreational facility outside of Fort Worth. We went to work immediately and

• investigated the scene and obtained critical evidence including witness statements and photographs;
• worked with his doctors, health insurance carrier, and employer to make sure he got the medical treatment he needed;
• located a secondary health insurance policy;
• gave our client a large loan since he could not perform his physical job. And we never charge interest, not wanting to add to our clients' financial burden (and it is outlawed in the Bible);
• researched similar cases across the country and contacted attorneys who had handled them to get more information;
• contested his health insurance company's attempt to be repaid for the medical bills it had paid;
• kept our client and the insurance companies updated with case developments; and
• sent a lawsuit petition and discovery documents we were about to file in court to the business's insurance company.

For confidentiality reasons, we are not permitted to disclose further information.

The excellent results

Mr. Berenson entered into lengthy negotiations and was able to make the insurance company pay $180,000.00. Then he cut down medical bills that had to be repaid due to subrogation from $33,000.00 to $21,000.00. He also cut his legal fee and expenses so his client would get more money. His client received $100,000.00 in his pocket and was thrilled.

I have been asked by several clients if the coronavirus will affect their car wreck cases. No one knows as we are in uncharted territory. On top of the anxiety we are all living through, as a Fort Worth personal lawyer, I am very concerned how the virus could affect injured people's medical treatment and personal and financial outcomes. Here are some specific questions I have.

       1. Will fewer police respond to crashes?

It is essential that the police come to the scene of a crash and determine which driver was at fault. Without a favorable police report and officers who can testify in court, a car accident can become a "he said/she said" dispute. These are often denied by the other driver's insurance representatives so a lawsuit must be filed. Juries may not know which driver to side with. Furthermore, the police report contains important information that the car accident lawyer can use to help his client win the case. This includes the names and identifying information about all drivers, insurance policies, date, time, location, speed limit, weather, vehicle damage, witness's observations, admissions of fault made, injuries reported, alcohol use, etc. My office obtains the police report for our clients at no charge. The sooner we get the report, the sooner we can get to work.