There are multiple sources for insurance coverage which may be available to you if you have been injured in an automobile accident. Before you leave the scene of an accident, you should record the automobile insurance information for all parties involved in the accident. It can be confusing and difficult to determine who to bill for your treatment. To ensure that you meet statutory and contract deadlines, it is a good idea to speak to an attorney who practices in this area of the law.
Start By Getting Information
Obviously, it is very important to provide a thorough history to your doctor during the initial visit following a motor vehicle accident. You should report how, where, and when the injury occurred. You should not assume that because you have been injured in an automobile accident, automobile coverage is the sole avenue for claims reimbursement. Here is a list of types of coverage which may be available to pay your bills:
- Workers’ Compensation If you were injured in an automobile accident while “on the job,” the treatment charges should be submitted to the workers’ compensation insurance carrier first. In this circumstance, your doctor must accept the billing amounts allowed by the Workers’ Compensation Fee Schedule published by the Kansas Department of Labor. If your doctor is “authorized” by the Workers’ Compensation Carrier to treat you, there is no cap on the number of services which are covered. If you see an “unauthorized” provider, the workers’ compensation carrier will pay up to $500.
- Personal Injury Protection (PIP) Benefits Once it has been determined that workers’ compensation does not apply, or that those benefits have been exhausted, you should look for PIP coverage. Every Kansas automobile insurance policy must contain at least $4500 in PIP benefits. There is no fee schedule for PIP, but charges must be “reasonable and customary” for “reasonable and necessary” healthcare. In Kansas, PIP benefits cover the cost of treatment and lost income for individuals who have suffered an automobile-related accident, regardless of fault.
- Private or Employer-Related Health Insurance Once PIP coverage has been exhausted, claims should be directed to the patient’s health insurance carrier. If care is insured under a major medical plan in which your doctor is a contract provider, he or she must bill for treatment at a discounted contract rate.
- Medicare and Medicaid Medicare and Medicaid apply like other forms of health insurance. Once the PIP coverage has been exhausted, doctors who treat patients enrolled in these government programs should observe and comply with all rules and regulations for billing applicable to these programs.
- Third-Party Liability Coverage If someone else was at fault in causing the car accident, some other party might be legally responsible for your injuries and healthcare expenses arising from the motor vehicle collision. While your doctor will not be able to bill the liability insurance carrier directly, this is another source which may ultimately be available to satisfy your medical charges. Here, the rule again for charges is “reasonable and customary” for “reasonable and necessary” treatment.
Determining where to look for payment of motor vehicle accident related medical bills can be confusing. It is often beneficial to contact an attorney who will be willing to communicate with you and make sure that your medical charges are taken care of out of a settlement of your claim.
*Use of this website does not create an attorney-client relationship. The information on this site is not legal advice. You should contact an attorney for actual legal advice with Dickson and Pope, P.A. at 913-387-5510.
