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Persl Injury Settlement Insufficient-> Denied Untimely Filing Health Insr Claim

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Michele:
Thanks.  I need to know "how" things work.   :D

PMRNC:
For every carrier I worked with they trained us to ask this question whenever dealing with any WC, PI or auto injury "WHO has responsibility" Insurance carriers are in the business of "risk management" If a person is injured and receives a settlement from that injury, the carrier has a right to recoup any monies paid out in conjunction with that medical care. That's why I said a lawyer should be consulted because we don't know the terms of the settlement. The responsible party in the settlement may have only had to pay charges in "excess" of or for "pain and suffering". etc.  If there was a settlement I can only ASSUME their was legal counsel that signed off on the settlement. In any event the PT really doesn't have to do anything more than what they did, so the legal issue of responsibility is between the patient, carrier and attorney. PT is still owed that money from someone.

shanbull:
I'm sorry you have to deal with this stress, at our clinic we actually bill the health carrier right away when the auto policy denies a claim so that the patient doesn't have to worry about it. If we don't get any payment from either source we work with the patient's legal team to settle the bill with the at-fault party. It doesn't take that much extra work and it frankly makes me angry to see other clinics not doing this. Like you don't already have enough on your plate!

Even if there has already been a settlement for some portion of the bills, if this PT treatment was not included you still have rights to settle again. If you do not already have legal representation, call to get a free consultation with an attorney who specializes in injury law who will explain your options, and make sure you go with someone who only charges a fee if you win your case, with the other party billed for legal expenses and a settlement with any remaining balance on your treatment costs written off.

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