Jessica Mounce, a schoolteacher from Arkansas, was rear-ended in traffic in November 2013, a crash that pushed her car across an entire highway. Mounce, a Blue Cross Blue Shield Carolinas member, sought medical attention at in-network provider Carolinas Healthcare Systems. Not long after, she received a bill for the full amount of her care; CHS had placed a lien on the settlement she received from the at-fault driver’s auto insurance company. The hospital threatened to turn the bill over to collections if the amount wasn’t paid in full.
The law isn’t clear
WSOCTV 9 contacted CHS about using a debt collection company to recover money from auto insurance settlements for medical bills. The hospital declined an interview, but responded with a statement (emphasis ours):
“For traffic accidents, the responsible party could be the patient’s health insurer or auto insurance company, the auto insurance company of the other drivers or an attorney who is negotiating a settlement.
We either contact patients directly to obtain this information or work with another company who asks on our behalf. We make every attempt to identify health or auto insurance companies involved, but we may also seek payment from a negotiated settlement….
While we provide care to everyone, regardless of their ability to pay, we believe those with insurance coverage or the proceeds from an accident settlement should pay for the medical care they received as a result of that accident.”
CHS never submitted a bill to Mounce’s health insurance provider because Blue Cross Blue Shield would have paid a negotiated amount of the total bill. By going after Mounce’s pay out from the at-fault driver’s auto insurance, CHS stands to profit. However, Mounce pays a monthly premium for her health insurance; the car insurance settlement is her money to do with as she sees fit. CHS has no right to place a lien on that settlement until all other payment sources have been exhausted.
But you don’t have to suffer
Mounce has since filed a class action lawsuit against the provider, but she isn’t alone. Christopher Jenkins was injured in an accident with an at-fault driver in 2013 while riding a motorcycle in Greensboro. He was treated at Moses Cone Memorial Hospital, where he signed a general consent form that enabled the hospital to act as an attorney-in-fact for him regarding the collection of benefits. However, that same form bound the hospital to the terms of Jenkins health insurance providers Services Provider Agreement. Jenkins has also filed a class action suit against his provider.
Some states are being proactive about this behavior. According to WSOCTV 9, “Indiana legislators passed a law requiring hospitals to bill a patient’s accepted health insurance. Mecklenburg County Sen. Jeff Tarte said he’s watching the issue.
‘If it continues to be an ongoing problem or the courts can’t decide, it may be something the Legislature needs to look at,’ Tarte said.”
In the meantime, auto accident victims and other patients continue to improper billing practices by healthcare providers that leave them unable to pay for monthly bills and even daily expenses. If you or a loved one has been in an accident and received a full bill for medical services, call our experienced South Carolina auto accident attorneys today. McGowan, Hood & Felder LLC helps people throughout North and South Carolina in need of strong legal counsel. Call 803-327-7800 or contact us today for a free consultation.
Randy is the former President of the South Carolina Association for Justice. He has been certified by the American Board of Professional Liability as a specialist in Medical Malpractice Law which is recognized by the South Carolina Bar. Randy has also been awarded the distinction of being a “Super Lawyer” 10 times in the last decade. He has over 25 years of experience helping injured people fight back against corporations, hospitals and wrong-doers.
Read more about S. Randall Hood