Medical bills are often the first number people think of after an accident. They are also one of the most misunderstood parts of an injury claim in California. The amount on the bill is not always the amount you can recover, and the way your care was paid for can change the result. This article explains the basics.
Billed is not the same as paid
Hospitals and doctors often bill far more than they accept as payment. In California, past medical expenses are generally measured by the amount actually paid or still owed for the care, not the full amount on the original bill. If your health insurance paid a discounted rate, that rate usually sets the number.
How your care was paid for matters
Care can be paid by health insurance, Medi-Cal or Medicare, your own auto policy’s medical payments coverage, or through a lien, where a provider treats you now and is paid from the settlement later. Each has its own rules, and some must be repaid from your recovery. Knowing the rules for each source helps you keep more of the settlement.
Future medical care is part of the claim
A claim should cover the care you will need in the future, not only the bills you already have: surgery, therapy, medication and help at home. Future care is usually proven through your doctors and, in serious cases, a life care plan prepared by a specialist.
Liens and reimbursement
Health insurers, government programs and lien providers may claim part of your settlement. These amounts can often be reduced, but only if someone checks each one. We review and negotiate every lien so more of the money stays with you.
What to do
- Use your health insurance if you have it, and keep every explanation of benefits.
- Keep every bill and record, including pharmacy receipts and mileage to appointments.
- Tell your lawyer about every provider, so nothing is missed in the claim.
- Don’t sign a lien agreement you don’t understand. Ask first.
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