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  • Writer's pictureAhsan Malyk

Can A Hospital Refuse To Bill Insurance?

Imagine suffering injuries in a collision. Perhaps someone else's carelessness resulted in an automobile accident. Whatever the cause, you needed to go to the emergency department for treatment because your wounds were serious enough.

After receiving treatment, you were finally in a position to return home. You had the impression that everything was under control, and in many respects, you were right.

You are insured, and you supplied your insurance information while you were in the emergency room or as soon as you were able to speak clearly enough to do so, but now misunderstanding has set in because of this. But the hospital doesn't charge your insurance.

Instead, in order to recuperate payment for your medical care, they have filed a lien against you. Even worse, the hospital is billing you for the highest amount possible – as if you did not have insurance – rather than adhering to the reduced, negotiated costs they have agreed to with your insurance company.

This scenario might seem odd or even bizarre, yet it can happen to anyone and does, according to a recent piece in The New York Times. Accident victims who have health insurance find themselves subject to hospital liens after seeking treatment in hospitals in South Carolina or other states around the nation.

The news is equally unpleasant for accident victims who receive a payment as a result of their injury claim. The hospitals want as much of that compensation as they can get, and they are determined to do it. They frequently give patients a form to fill out while they are still in the emergency room.

When asked if they want their insurance to be billed even though the patient was not at fault for the accident, patients may have been misled by the form's phrasing. Some patients sign the form without understanding what they are doing. This includes people who, due to head trauma or other accident-related injuries, may not be deemed competent to make the decision at the time the form is offered to them.

Why don't all hospitals bill patients' insurance instead of using liens?

Since the early 20th century, when few Americans had health insurance, hospital liens have been a frequent practise. At the time, the goal was to persuade hospitals to offer emergency care to any patient in need, regardless of insurance coverage.

However, hospitals were entitled to lay liens on patients' real and personal property in order to protect them from suffering considerable financial loss as a result of patients failing to pay their bills even when they had the means to do so.

Of course, having insurance these days is much more typical than not. What motivates this billing procedure, then? Simply put: greed. pure avarice Hospital executives are aware that placing liens on patients rather than billing through their insurance will result in higher profits.

Hospitals may be able to get more money if there is a chance that the patient wins financial recompense in a personal injury lawsuit. The hospital places a lien on the patient and takes a cut of any settlement the injured party receives rather than billing the insurance company at the agreed-upon amount.

Are hospital liens legitimate in South Carolina?

Hospital liens, also known as healthcare provider liens or medical liens, are legal, even though the morality of some of the procedures may at times seem dubious. More so than others, certain states regulate this activity.

For instance, restricting the entire amount or percentage of the recovery award that hospitals are allowed to claim when a personal injury award is involved, or permitting only nonprofit hospitals to lodge liens.

In several states, hospitals are required by law to submit an insurance claim before filing a lien. The hospital may be obligated to charge both the patient's auto insurer and his or her health insurer if the patient was hurt in an auto accident. This method is thought to be more consumer-friendly.

These things are not regulated in South Carolina.

You should see a personal injury attorney if you or a loved one was hurt in a vehicle accident or other accident and sought treatment at a hospital that is currently refusing to bill your insurer for your care.

Hospitals who use these predatory billing techniques are fully aware of their actions. No amount of patient correspondence, including phone calls and letters, will be able to resolve the issue, and while you are occupied trying to persuade the hospital that they made a mistake and should be paying your insurance company, the unpaid bills will build and your credit score will plummet.

The personal injury lawyers at McGowan, Hood, Felder & Phillips, LLC in South Carolina have a track record of advocating for injured people. We check to see if the hospital is billing your insurance correctly.

If your insurance provider refuses to pay or decides to file a lien against any judgement you may receive, we also deal with them directly. We fight for you, and our track record of success in legal battles with hospitals speaks for itself.

We are aware that an incident like a car accident can be unpleasant and that customers may experience stress as a result of a lawsuit. We also understand that for injury victims, it is usually even harder to watch as the majority of your settlement is given to hospitals and insurance companies in what some may view as a form of legal thievery.

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