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Birmingham, Alabama

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Jon Lewis
Jon Lewis
Attorney • (888) 295-7409

Is Your Health Insurance Accepted

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Hospitals have a new practice in Alabama. It’s called, “Let’s Wait and See What the Patient Recovers in the Accident.” What do we mean? We’ll give you an illustration below.

Let’s say a person is involved in a car wreck and is injured severely. The person is taken to a hospital in Alabama, has surgery, and recovers. When the injured person is admitted to the hospital, the hospital gets the BlueCross BlueShield information so they can bill BlueCross. But, the hospital never bills BlueCross. Instead, the hospital files a Hospital Lien against the individual. Why?

Well, hospitals have contracts with BlueCross. If you go to the hospital for treatment, the hospital agrees to accept payment from BlueCross based upon the contract the hospital has with BlueCross. For example, if your hospital bill is $10,000.00, BlueCross will typically only pay $5,000.00 or $6,000.00 of the bill, and the rest disappears into thin air. But, the Hospital Lien is for the full $10,000.00. So, instead of getting only $5,000.00 from BlueCross, the hospital will hold up the person injured in the accident for $8,000.00 or $9,000.00 which that person recovers from the other driver’s insurance carrier.

Taking the example above, this significantly affects the injured individual. If the individual settles her case for $25,000.00, she would recover $16,000.00if she has to pay the hospital $9,000.00. Had BlueCross paid the hospital $5,000.00, she would recover $20,000.00 (the person must pay back BlueCross which is called subrogation), and the hospital would have been paid the same amount it would have accepted had the person not been in an accident. In addition, the injured party would have probably recovered even more than $20,000.00 because BlueCross is usually reasonable and will take less than the $5,000.00.

Hospitals in Alabama have gotten greedy, and they have found a way to hold injured parties’ feet to the fire. The example above is a small example. Imagine if the bills are $200,000.00. Who do you think will need the money more? The hospital or the injured person?