[Music] welcome to the AutoAccon Attorneys podcast brought to you by the Auto Accident Attorneys Group where our motto is simple We take care of you While we're known for helping people navigate the aftermath of auto accidents this podcast is about so much more You'll find helpful episodes on what to do after a crash obviously how to deal with insurance companies adjusters tips for preventing accidents in the first place even But that's not where it stops This show is about taking care of people in every way we can That means talking about topics that impact your everyday life From how to safely prune trees in your yard to the importance of adopting pets from local shelters All of this goes in line with the Auto Accident Attorneys Group brand of taking care of others Each episode is designed to offer thoughtful often overlooked advice to help you stay informed empowered and cared for whether you're dealing with an accident or simply trying to improve your life and your community Because at the end of the day taking care of you isn't just something we say it's what we do And in a means to take care of you today on today's episode I want to talk to you about your health insurance We've spoken a lot about auto insurance not much about health insurance Now I don't have much advice in terms of what kind of health insurance for you to choose because well that's not my expertise What I do want to talk to you about is using your health insurance after an auto accident And I want to become even more specific and talk about using your health insurance at the hospital or emergency room after an auto accident The reason why that's important is because medical clinics have different billing rates Unfortunately they've got their cash patient rate they've got their Medicare rates they've got their contractual rates with private health insurance companies and then they've got the rates for auto accidents which is their unadjusted build amount I'm sure if any of the listeners are uh have been involved in not just an accident but you've had to go to the hospital you've had to go to the emergency room specifically for something in an emergency situation because of some form of acute trauma or illness When you look through your invoice you'll see uh line items where things are build at certain amounts One of the the more famous ones I remember that I personally saw was ibuprofen I forget how many milligrams of ibuprofen but it was uh I want to say like $180 This is prescription strength Advil is what we're talking about Now they bill it at that amount but then in those invoices if you look underneath that line item you'll see that there is an adjustment So it'll say for example $180 and then the adjustment is negative $178 So it turns out that they end up billing you $2 Now when you're involved in an auto accident the billing department of emergency rooms don't really have an incentive to use your health insurance because then they're going to be beholden to the contracted for rate of whatever whether it's Blue Cross Blue Shield or Anthem or United Healthcare whoever it may be those private entities have contracted with the the hospital systems and said for this particular diagnosis code this is how much regardless of what you bill this is how much we'll pay So the billing department of the hospital it behooves the billing department of the hospital or emergency room to not use the health insurance when you're involved in an auto accident because what they can do is actually file a lean against your bodily injury settlement So if you're involved in an auto accident and you get hurt and you go to the emergency room the hospital is incentivized to not bill you to not use your health insurance but instead to file a lean against your inevitable or what they determine to be an inevitable settlement that's coming from the auto accident case I paused on the inevitability part because when you go to the emergency room one you don't know if you're actually going to win a case or not You don't even know if there's insurance available for you to use Assuming there is insurance to use you still do not want the hospital to file that lean against your bodily injury settlement directly because they're going to use remember the discussion we just had about the itemization of the ibuprofen they're going to use that line item They're not going to make any adjustments They'll file a lean for the amount that is on each of those line items That is what they bill That's the amount of the lean that they will file against your settlement That means had you used your health insurance a an invoice would have been reasonable to be around $1,200 $1,800 for your emergency room visit if you don't use your health insurance and they follow a lean that lean could be upwards of $8,500 $10,000 maybe even higher One of the ways that it seems really benign uh one of the ways or I hate to say tactic because it makes it seem like I'm painting these people that work in the billing departments of emergency rooms to be malicious and evil people and they're not They're just conducting business But when you're injured and you're in an emergency room you're accustomed to your expectation is for the people there to take care of you in your best interest The medical professionals absolutely The nurses there the staff the doctors they are there to make sure you're going to be okay Billing department people they work for the business entity that hospital system Whether or not it's a for-profit or nonprofit it's still a business and they are looking to bill at the highest rate possible so that they could get the highest reimbursement rate possible So when they come to you and in in your uh I was going to say office in your room in that little patient suite that you're in or in your bed with they'll pull the curtain and they come talk to you when they see that you brought in especially by ambulance because of an auto accident One very common tactic that they use is when they speak to you they they come to you and say "Because you're involved in an auto accident it was not your fault you need not use your health insurance The person that caused the accident is responsible for your payments which is 100% true The part that they're not sharing is that yes that person that was at fault is responsible for the payments to be made but if you pay the payment to the hospital it's going to be significantly exponentially lower than if they file a lean on your case and get what their itemized bill amount is on their invoice Again if you pay it through your health insurance it'll be let's call it $1,500 If you do not present your health insurance you're going to get build at the rate at which the hospital bills without any adjustments for the contractual rate And the outstanding invoice will be let's call it $10,000 The $10,000 isn't coming out of your pocket It is coming from the at fault driver But the at fault driver's insurance policy or if whether they're paying personally if that 10,000 doesn't go to the hospital that's money that goes into your pocket So yes the outfall driver is ultimately responsible but they're only responsible for one settlement amount Everything that's associated with that settlement amount has to come out of that check or that lump sum of money So if the hospital is taking 10 sure you didn't pay for it because you didn't go out of your pocket to pay for it but you kind of did pay for it or rather you're at a disadvantage by not paying for it upfront I'm probably not doing this concept justice right now Let's try it another way Let's just give you the advice on on what to do when you're involved in an auto accident and you have health insurance and you've been taken to the emergency room The best thing you can do for yourself is to present your health insurance information to the billing department Let them know I have health insurance Here it is Present it to them so that they submit that claim Just like auto claims if you don't submit the bills to your health insurance company they have different windows of time But if that period of time that window the opening of the window in which you can submit a claim for your health insurance to pay medical expenses that you've incurred if that window closes the health insurance is no longer liable to pay which is what the hospital wants in an auto accident case And then the hospital will go and file a lean against your bodily injury settlement And the hospitals actually have their own attorneys that do just this They have attorneys that will take the emergency room patients that are being seen after an auto accident And they will not submit those bills to the injured person's health insurance and instead forward that file to their attorney and that attorney will file a lean with the state And when the injured person ends up having a bodily injury settlement or a verdict after trial there is a lean that's going to have to be paid back before the victim gets any money from the settlement It's a weird loop-de-loop I don't know how else to describe it The only thing I can tell you is that it behooves you to not fall into this trap of thinking "Well it's not my fault I didn't do anything wrong so I shouldn't have to pay That's the wrong mentality This is all a game and the rules have been set And yes at your core your emotional center your feelings of what's right and wrong the utopia of what the world should be all of those things aside your best bet is to learn the rules of the game so that you could benefit in the best way possible And this isn't gamesmanship in any way This isn't some sort of unethical life hack This is a It shouldn't even be a hack This is just how the system works But most people don't know So for that reason I guess it is a hack But the hack is to make sure that if you have health insurance regardless of whether or not you believe the other person is ultimately responsible which they are don't let that feeling prevent you from presenting your health insurance card to the emergency room billing department have the hospital bill your health insurance You're going to be way better off in that situation Use your health insurance Especially it's if if it's in the beginning of the year If you get into an auto accident in January or February and the person that hit you has auto insurance so you know that everything's going to get paid Hopefully you know everything's going to get paid use your health insurance because whatever deductible amount that you had it's going to get reimbursed from the auto accident case And now you can treat for the rest of the year the remaining period of enrollment in that health insurance without having to worry about your your deductible or your co well you probably still have a co-ay but sometimes on some policies the co-ay will go away as well So anyways always present your health insurance if you have it after an auto accident to the hospital Do not let the hospital confuse you Do not let the hospital lull you into a false sense of security that you need not worry about the payment because ultimately you do That's another thing Let's go back to this utopia This other person caused this accident You're injured your your emotions your feelings your sense of right and wrong The utopia that you live in tells you that person is responsible Well what if that person's uninsured what if they don't have money yeah they caused damage to you but if there's no money to be had to to support you to reimburse you to compensate you what are you what are you going to get blood from a rock it's not going to happen You can try and pursue them and sue them personally File a lawsuit against them personally You might get a piece of paper says "Hey this person owes you $50,000 for damages they caused because of that auto accident in January If they don't have the money you just have a piece of paper You're not going to be able to pay your medical bills with that piece of paper You can't submit a verdict to pay your mortgage You can't pay off any loans with a verdict and not the piece of paper that that has a verdict on it Anyways hell you probably can't even sell it to a downstream creditor If you did it would be pennies on the dollar You might be able to sell a $50,000 verdict depending on the person depending on the defendant You might get a couple bucks out of it The point is stop living in a utopia Stop thinking that there's this sense of right and wrong and and the way they're trying to sell it to you rather Right and wrong exists Morality exists That's not what I'm saying Don't get this twisted There are ethics But there are also rules to these games Just because the other person is at fault does not mean that you should not present your health insurance at the emergency room to get it paid for That is your best bet at receiving the highest amount of your settlement of what's left of your settlement Which also reminds me you know being a plaintiff's attorney that works on a contingency fee basis the fact that you get charged a lower settlement on a contingency fee does not necessarily correlate to the client ending up with more of the net settlement in their pocket There's so many things that go into the valuation of a case One is the ultimate number How big of a settlement i would rather pay 40% on a $100,000 settlement than 20% on a $18,000 settlement I'm going to end up with more money Then the other aspect is the negotiation of bills and leans and other invoices that have to be reimbursed or benefits that have to be paid back because some other entity paid for those benefits Now that you have a bodily injury settlement they have a right of reimbursement Just because a firm charges a lower percentage doesn't mean that you're going to end up with a higher net settlement Look at the numbers They make sense You don't have to take my word for it You're going to have to get the data though You could look at our numbers and maybe if there's another firm that uh advertises lower fees we'll put their numbers up and you guys can we'll put it up on on Google and you guys can take a look and see how this math maths I'm going to wrap it all up again and just implore you viewers listeners if if you're listening to to this without the video hear my words It doesn't matter that somebody else is at fault when you're in an emergency room situation and they want to bill you Give them your health insurance information It's what's best for you I'm going to try I tried to ASMR it I I'm going to try and yell it I want you to know the way that I implore you guys to make sure that you carry uninsured underinsured motorists protection I want to implore you to use your health insurance when you need it in emergency rooms after an auto accident If you don't use it you lose it You understand all right Well I sure do wish this was a live show so I could take questions because I think that there's a lot of nuance issues around using health insurance and emergency room situations and I feel like listeners probably have some questions of their own Uh so maybe what I'll do is if you guys post go to our website www.t a a agr.com That's the aaagroup.com We have a forum If you have any questions on on this topic post the questions there If we get enough of them maybe we'll have you guys on or we'll schedule a live podcast so you guys can call in I'll take the questions live respond to them live That way there's a we can cover more bases on exactly what all of this means in terms of health insurance and auto accident cases If there's one thing that I can ask you to remember is if you're taken to the emergency room after an auto accident and they tell you not to worry about payment because someone else is at fault thank them for their service and insist that they take your health insurance and process the claim through your health insurance and then call the auto accident attorneys group so you can get the highest net settlement possible Uh again go to our forum Uh ask questions post questions If you see this on social media or if you're watching this on YouTube you want to leave a comment If you ask a question in the comment section I'll answer it there Um subscribe to our channel Share this video with people that you think might get some benefit out of it Continue to tune in Every week I'm going to do my best to take care of you and give you a piece of information that I believe doesn't readily exist in the world On that note I love you guys Take care