Motor Vehicle Accident billing (MVA)

[arvsun]

Hi

We have a patient who wants us to bill third party MVA company? We are family practice. Is it advisable? Does it take long and is the return rate good enough to warrant it?

Thanks so much
AG

[shanbull]

The return rate is usually better than health insurance billing, but the timing of payment can vary greatly depending on what the status of the auto claim is. If there's still $ left for med pay/no-fault you can expect to receive 100% of your billed price fairly quickly. If it's exhausted, you will have to communicate with the patient's attorney to make sure that you are attached to the case when it goes into arbitration or litigation and settlements can take years to finish winding their way through the legal system/lawyer negotiations. In my state we can bill the patient's health insurance (and we do not have to accept the contractual adjustments from health insurance payments) in the meantime to keep revenue coming in but the rules for this may be different for you.
So it's up to you, I'd contact the auto claim adjuster to see how much is left in available funds and then decide based on that whether you can take on the patient. If the funds are exhausted I would probably not take this on as your first auto case unless you are ok with not seeing payment for a while.

[DMK]

You can bill the 3rd party insurance, but the funds ALWAYS go to the patient and then only after the claim has been settled.  That often takes years.  Your best option is to encourage the patient to use their own Auto insurance if they have Med Pay, then the two insurance companies will square up when the claim is finished.  The patient shouldn't have an out of pocket, and you'll get paid faster.

If they use their health insurance, all deductibles and co-pays still apply.  Their health insurance will recoup anything they paid out when the claim settles.

[PMRNC]

You can bill the 3rd party insurance, but the funds ALWAYS go to the patient and then only after the claim has been settled.  That often takes years.  Your best option is to encourage the patient to use their own Auto insurance if they have Med Pay, then the two insurance companies will square up when the claim is finished.  The patient shouldn't have an out of pocket, and you'll get paid faster.

If they use their health insurance, all deductibles and co-pays still apply.  Their health insurance will recoup anything they paid out when the claim settles.

Just as a note..this depends on state.. no fault, not, etc. We always ask for all info including NF carrier, adjuster, adjuster's phone, and attorney if one is on it. We can then determine if an LOP is sent out which guarantee's our payment.

[DMK]

Thanks for that clarification, Linda.  I'm in California, so that's all I know about.

We're running into more and more people who don't have Med-Pay on their auto policies.  It's the cheapest insurance there is.  Seriously only a couple dollars a month for a large dollar amount of coverage. 

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