HOSPITALS REFUSING TO BILL INSURANCE AFTER A CAR ACCIDENT

You may have recently seen in the news articles regarding hospitals profiting from victims of car accidents. It has been a long-standing silent practice.  Some hospitals around the country, including here in Nevada, have refused to bill the patient’s aka the victim’s health insurance when they have been involved in a car accident. They do this because they want to receive a higher rate through the persons auto insurance or settlement to the detriment of the injured person. They do this by refusing to bill the victim’s health insurance and then billing the patient directly.  They have even put liens on their personal property and/or their settlement. This is against Nevada Law. In fact, Nevada statutes are quite clear on this issue.   Nevada law clearly states that when a person receives hospital care, the hospital cannot collect on any amount that the hospital is owed from any party involved until the hospital bill has been submitted to the injured person’s health insurance. That law is codified in Nevada revised statute 449.757 and is stated below in its entirety:

NRS 449.757  Limitations on efforts of hospitals to collect; date for accrual of interest; rate of interest; limitations on additional fees.

1.  When a person receives hospital care, the hospital must not proceed with any efforts to collect on any amount owed to the hospital for the hospital care from the responsible party, other than for any copayment or deductible, if the responsible party has health insurance or may be eligible for Medicaid, the Children’s Health Insurance Program or any other public program which may pay all or part of the bill, until the hospital has submitted a bill to the health insurance company or public program and the health insurance company or public program has made a determination concerning payment of the claim.

2.  Collection efforts may begin, and interest may begin to accrue on any amount owed to the hospital for hospital care which remains unpaid by the responsible party not sooner than 30 days after the responsible party is sent a bill by mail stating the amount that he or she is responsible to pay which has been established after receiving a determination concerning payment of the claim by any insurer or public program and after applying any discounts. Interest must accrue at a rate which does not exceed the prime rate at the largest bank in Nevada as ascertained by the Commissioner of Financial Institutions on January 1 or July 1, as the case may be, immediately preceding the date on which the payment becomes due, plus 2 percent. The rate must be adjusted accordingly on each January 1 and July 1 thereafter until the payment is satisfied.

3.  Except for the interest authorized pursuant to subsection 2 and any court costs and attorney’s fees awarded by a court, no other fees may be charged concerning the amount that remains unpaid, including, without limitation, collection fees, other attorney’s fees or any other fees or costs.

      (Added to NRS by 2007, 1497; A 2011, 1525)

This practice is often used against some of the most vulnerable patients. The statute does not differentiate between private health insurance, Medicaid or Medicare.  However, because the reimbursement rates are lower for hospitals through state and government programs of insurance, (which hospitals have contracted for based on the volume of patients they received as the trade-off) these are often times the patients that hospitals refuse to bill their insurance. Some Hospitals engage in this practice intentionally to receive higher payments than what they are legally contracted to receive from Medicare or Medicaid. At the Law Offices of TheOneLawyer.com, we immediately notify hospitals to bill our client’s health insurance and provide their health insurance information as soon as possible so that this does not occur to the detriment of our clients. At the Law Offices of the TheOneLawyer.com, we protect our clients from the very beginning of the case through to the end to make sure that they get the full compensation that they are entitled to receive.

There is also a separate statute that is very clear and outlines that insurance companies must accept the contracted rate from the insurance company that they are contracted with under the persons healthcare policy. In instances where insurance companies have refused to bill the health insurance policy from the start, we have been successful in making them only accept what they would’ve been paid under the contract and taking a reduction from there. In a separate blog we will talk about subrogation. That is where a health insurance company can get paid back from proceeds from your automobile insurance settlement. However, they are only entitled to recover the amount that was paid and not the full amount of the bill. Hospitals will try to recover their full billing, which as most people know, is grossly inflated rather than the contracted rates they have with insurance companies. If you’ve been in a car accident, call our office immediately to make sure that you get the full compensation that you deserve and are entitled to and do not get taken advantage of by a hospital.

NRS 449.758  Limitations on efforts of hospital to collect when hospital has contractual agreement with third party that provides health coverage for care provided; exception.

1.  Except as otherwise provided in subsection 2, if a hospital provides hospital care to a person who has a policy of health insurance issued by a third party that provides health coverage for care provided at that hospital and the hospital has a contractual agreement with the third party, the hospital shall proceed with any efforts to collect on any amount owed to the hospital for the hospital care in accordance with the provisions of NRS 449.757 and shall not collect or attempt to collect that amount from:

(a) Any proceeds or potential proceeds of a civil action brought by or on behalf of the patient, including, without limitation, any amount awarded for medical expenses; or

(b) An insurer other than a health insurer, including, without limitation, an insurer that provides coverage under a policy of casualty or property insurance.

      2.  This section does not apply to:

(a) Amounts owed to the hospital under the policy of health insurance that are not collectible; or

(b) Medicaid, the Children’s Health Insurance Program or any other public program which may pay all or part of the bill.

3.  This section does not limit any rights of a patient to contest an attempt to collect an amount owed to a hospital, including, without limitation, contesting a lien obtained by a hospital.

       4.  As used in this section, “third party” has the meaning ascribed to it in NRS 439B.260.

       (Added to NRS by 2011, 1524)

THE HOSPTIALS ARE BOUND BY THE FAIR DEBT COLLECTION PRACTICES ACT

      NRS 449.759  Manner of collection.  A hospital, or any person acting on its behalf who seeks to collect a debt from a responsible party for any amount owed to the hospital for hospital care must collect the debt in a professional, fair and lawful manner. When collecting such a debt, the hospital or other person acting on its behalf must act in accordance with sections 803 to 812, inclusive, of the federal Fair Debt Collection Practices Act, as amended, 15 U.S.C. §§ 1692a to 1692j, inclusive, even if the hospital or person acting on its behalf is not otherwise subject to the provisions of that Act.

       (Added to NRS by 2007, 1498)

At TheOneLawyer.com, we are here to serve our community and provide legal services in the Henderson and Las Vegas area. We are a boutique law firm providing experienced and personal representation to injured clients.  At the Law Offices of Laura Payne-Hunt, TheOneLawyer.com we provide professional and personal service to each and every one of our clients on various legal matters and have over 15 years of experience in reviewing insurance policies and in Nevada insurance law.   If you have a question regarding any type of personal injury or paying your medical bills from an accident, please do not hesitate to call the offices of TheOneLawyer.com and speak directly to attorney Laura Marie Payne-Hunt, Esq. a Henderson Injury Attorney for over 15 years.  Laura is recognized as one of Nevada’s Top 100 Lawyers.  She has the experience and knowledge to obtain the maximum settlement you deserve.  Please call our office if you or a loved one is injured.  We can make sure that you receive the care you need and deserve and advise on how to preserve evidence.  

At our office, we are experienced in helping injured victims get the compensation they are entitled to.  Insurance companies never have the best interest of the injured person at the top of their priorities.  They want to pay as little on every claim as possible.  Having worked for an insurance company as an attorney for 9 years before opening my boutique law firm specializing in helping injured people, I have reviewed thousands of auto accident claims and policy provisions.   

At the Henderson and Las Vegas Accident injury law offices of TheOneLaweyer.com, Laura Marie Payne-Hunt and her staff are here to help you and your family in the event that accidents and tragedies occur.  For any of your legal needs, do not hesitate to contact our Henderson and Las Vegas Accident injury offices.  TheOneLawyer.com is a boutique, family-owned law firm that specializes in helping injured people and the community of Las Vegas and Henderson Nevada with legal issues involving auto accidents, wrongful deaths, slip and falls, truck accidents, injuries to children, bicycle accidents, dog bites, product liability claims, and all types of injury claims.  Please do not hesitate to call us anytime you have a legal question or you or a loved one has sustained an injury at 702-450-(HUNT) 4868 and text 24/7 at 702-600-0032.