Is that hard to believe? Well, it’s true.
Let’s say you are in a Tennessee car wreck. It’s the other driver’s fault. You are injured. You go to a Tennessee emergency room for your injuries and you present them with your health insurance card. But the hospital refuses to take your health insurance; maybe, they claim, your health insurance company won’t “let” them charge your care to your health insurance (a lie); or maybe they claim state or federal law won’t let them charge your care to your health insurance (another lie); or maybe they just say “that’s our policy”. Instead, they want you to sign a piece of paper (called a lien) that gives them the right to take any charges you rack up at the hospital (and the hospital gets to decide how big those charges are going to be-you don’t) out of any settlement or verdict you get from the at-fault driver’s insurance company. You’re hurt, you need treatment, you are under duress-so you sign. Many months later, you settle with the at-fault driver’s insurance company and find out that most of your settlement is going to the greedy hospital. You now have been victimized twice by the accident-once when the at-fault driver injured you and now by your nice, community hospital.
WHY SHOULD YOU CARE WHETHER THE HOSPITAL TAKES YOUR HEALTH INSURANCE-AREN’T THE CHARGES THE SAME?
AND YOU SHOULD CARE BECAUSE IT CAN COST YOU THOUSANDS OF DOLLARS
See, your health insurance, on your behalf, has negotiated very reduced rates for your medical care, whether or not you needed the care because of an accident. Your health insurance card is like a Costco or Sam’s Club card. But, instead of getting a discount off your groceries, it gets a discount off your medical care. So, if the hospital bills your health insurance. The hospital has to accept this extremely reduced rate, usually 20 to 30 percent of the made up and exploitive charges the hospital is trying to squeeze from you.
THE TENNESSEE HOSPITAL LIEN STATUTE
If the hospital avoids submitting the bill to your health insurance company, they can file a lien against your accident claim under the Tennessee Hospital Lien statute which says in pertinent part:
… (a) Every person, firm, association, corporation, institution, or any governmental unit, including the state of Tennessee, any county or municipalities operating and maintaining a hospital in this. state, shall have a lien for all reasonable and necessary charges for hospital care, treatment and maintenance of ill or injured persons upon any and all causes of action, suits, claims, counterclaims or demands accruing to the person to whom such care, treatment or maintenance was furnished, or accruing to the legal
representatives of such person in the case of such person’s death, on account of illness or injuries giving rise to such causes of action or claims and which necessitated such hospital care, treatment and maintenance.
To keep the hospital from filing a lien under the Tennessee Hospital Lien Statute, you need to: 1) remind them that as a member of your health insurance plan they are contractually obligated to file their charges with your health insurer; and 2) that until you actually see money from the at-fault driver’s insurance company, you don’t know if there is any other way to pay the bill other than through your health insurance company.
DESPITE THE TENNESSEE HOSPITAL LIEN ACT, HOSPITALS HAVE CONTRACTS HEALTH INSURANCE COMPANIES THAT REQUIRE THE HOSPITAL TO SUBMIT THE BILL TO YOUR HEALTH INSURANCE COMPANY
BUT IF THE HOSPITAL GETS PAID LESS FOR MY ACCIDENT RELATED CARE, DOESN’T THAT MEAN I GET A LOWER SETTLEMENT?
No, it doesn’t. If you have health insurance, hospitals generate two important “charge” numbers on the medical bill. The first charge is the amount the hospital would charge if you had no health insurance. That’s the big number. The second charge is the amount, after contractual write-offs, that the health insurance company will pay. The only charge we at Dennis and King submit for our clients, is the larger charge—-the amount the hospital would bill you if you had no health insurance and the amount the hospital wants to squeeze out of your car wreck verdict or settlement if you are unable to make them submit your bill to the health insurer.