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How Inflated Medical Bills Are Causing You to Pay More for Your Insurance Coverage

When defending an insurance company, it is quite common for medical bills to serve as the foundation for evaluating the exposure to the company and affords, at least in theory, a reasonable range to negotiate a settlement with the claimant. However, inflated medical bills are making the negotiation process more challenging by increasing a company’s exposure to the point of utilizing the full amount of the purchased coverage, or even exceeding the limits of the insurance policy at issue.

Time Magazine published an insightful article on this issue titled Bitter Pill – Why Medical Bills Are Killing Us. The article reveals some extremely troubling trends in medical billing practices that significantly affect personal injury litigation and medical debt litigation.

Insurance companies from various sectors (e.g., homeowners insurance, automobile insurance, traveler’s insurance, etc.) must routinely engage in litigation if a policyholder disputes a denied claim or refuses to accept a reasonable settlement offer. One of the most common forms of litigation involving insurance coverage is a disputed personal injury claim. Generally, the claimant, or their attorney, will submit a settlement package early on in this process seeking a dollar amount to resolve the claim prior to filing a lawsuit. In many instances, due to the aforementioned inflation of medical bills, the settlement package contains excessive economic and non-economic damages that hinder the timely and effective resolution of the dispute. This may result in the amount paid on the claim being inflated, especially if the bills are entered into evidence at trial.

Inflated Medical Billing is Rampant

It is fairly well known that health care providers may charge more than what is necessary in order to cover the cost of care provided to people who lack health insurance. This is called the “free rider” problem in our healthcare system. However, the Time Magazine article highlights some rather astounding practices to indicate that certain medical bills are inflated many times beyond just covering the cost of uninsured patients.

For example, the article highlighted an instance where a simple chest x-ray was billed at $283.00 when Medicare typically pays around $20.44 for the same procedure. In addition, the article highlighted a $36.00 charge when a nurse drew blood and an accompanying $78.00 for lab tests which brought the total cost for blood work on one patient to over $15,000.00. Medicare would have only paid a few hundred dollars for this type of blood work.

The Time Magazine article is essential reading for anyone working in the insurance industry. It reveals just how misleading and inflated the “sticker price” can be for certain medical procedures. This means, when a claim is submitted alleging harm, a thorough analysis must be conducted of what exact testing and medical care was provided to the claimant.

Defending Insurance Companies In Cases Involving A Variety Of Claims

The Brownsville insurance defense attorneys at the law firm of Colvin, Chaney, Saenz & Rodriguez, L.L.P. know how to effectively and efficiently defend major insurance companies against a broad range of claims. That is because our legal team conducts a thorough investigation into the incident that led to the claim and our only concern is to secure a resolution that most benefits our client.

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Brownsville
Office

1201 East Van Buren St.
Brownsville, TX 78522

Phone: 956-542-7441
Fax: 956-541-2170

Edinburg
Office

323 West Cano, Suite 100
Edinburg, TX 78539

Phone: 956-542-7441
Fax: 956-380-0254

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Colvin, Chaney, Saenz & Rodriguez, L.L.P., represents clients throughout South Texas and the Rio Grande Valley, including people living in Brownsville, Harlingen, McAllen, Edinburg, Laredo, Corpus Christi, San Diego, Alice, Kingsville, Rio Grande City and other communities in Hidalgo County, Duval County, Jim Wells County, Kleberg County, Starr County, Cameron County, Webb County and Nueces County. -Site Map-

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