By: Will Love, Director of Denials and Underpayments<\/strong><\/p>\nOver the previous five decades, motor vehicle accidents (MVAs) have increased emergency department (ED) visits in metro-
\narea hospitals. While most MVAs cause minimal injury, injured motorists are lawfully entitled to a hospital visit, by
\nambulance if needed, following a car crash. With EDs daily treating MVA patients, it is important for hospitals to
\nunderstand their options when seeking reimbursement on an MVA claim.<\/p>\n
Depending on a hospital\u2019s trauma classification, MVA accounts usually constitute 1 to 3% of a hospital\u2019s A\/R. Most
\npatients will have moderate injuries, requiring only pain medication and an x-ray, MRI, or CT scan to check for internal
\ninjuries. However, a small number of trauma patients will require admission for emergency surgeries, intensive care,
\nand rehabilitation.<\/p>\n
Regardless of severity, MVA patients can be challenging to register. These patients may not have insurance information
\non hand, and if they were not at fault, may refuse to bill their own insurance for their treatment. Without an
\nexperienced team to guide the patient through the reimbursement process, hospitals risk these accounts falling into
\nself-pay and inflating bad debt. Below are tips for maximizing returns on MVA accounts:<\/p>\n
Understand the risks and opportunities of MVA reimbursement<\/strong><\/p>\n\n- \n
\n- A core distinction between accident payers and managed care payers is that hospitals will typically have no contracts with the former.<\/li>\n
- With no contracts to govern reimbursement rates, hospitals may collect high rates of reimbursement, even 100%, depending on the policy limits compared to the billed charges.<\/li>\n
- However, hospitals will not have the same collection rights as contracted payers. The accident policy may exhaust before the bill is paid and may not pay directly to the hospital without the member\u2019s consent.<\/li>\n
- Thus, while accident insurance can fetch higher rates of return, it may also fetch minimal or no reimbursement if not carefully vetted.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
\nComply with your state\u2019s regulations<\/strong><\/p>\n\n- \n
\n- Each state has different laws regarding MVA-related medical bills. Most states are tort-based \u201cat-fault\u201d states, where the person deemed at-fault for the injury will be responsible for compensating the injured party.<\/li>\n
- A few states, however, are \u201cno-fault\u201d states, where each injured party is expected to pay for their own injuries, regardless of who was at fault.<\/li>\n
- Whether or not your hospital resides in an at-fault or no-fault state will determine your reimbursement methods on MVA accounts.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
\nPursue both first- and third-party benefits<\/strong><\/p>\n\n- \n
\n- First-party benefits are paid out by one\u2019s own accident insurance; whereas third-party benefits are paid out by someone else\u2019s accident insurance.<\/li>\n
- In a no-fault state, a patient\u2019s first-party PIP (personal injury protection) will be the primary insurance responsible for the claim. Depending on the state\u2019s regulations, PIP may pay the entire claim, regardless of charges, or may exhaust it before the claim is paid in full.\u00a0 When PIP exhausts, hospitals maintain rights to bill the remaining balance to a secondary insurer.<\/li>\n
- In an at-fault state, patients and hospitals will have more options when coordinating benefits. A patient may carry optional first-party medical benefits on their auto insurance which can pay as primary.\u00a0 However, if patients carry no such benefits, the hospital can bill the patient\u2019s managed care or submit a lien against a patient\u2019s third-party personal injury settlement.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
\nUtilize your lien rights<\/strong><\/p>\n\n- \n
\n- Many states permit hospitals to pursue reimbursement through a lien on a patient\u2019s personal injury settlement. A lien will require the insurer or the patient to reimburse the hospital before the personal injury claim is settled.<\/li>\n
- Liens can be filed when either the patient does not carry or elects not to bill commercial health insurance.<\/li>\n
- When filing a lien, hospitals will need to understand their state\u2019s regulations, including how to legitimize or \u201cperfect\u201d the lien, and how their reimbursement will be calculated.<\/li>\n
- Hospitals will also need to follow up with the insurance and\/or patient regularly to check on the status of the settlement and negotiate a reduction if warranted.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
<\/p>\n
When collecting on an MVA account, hospitals should be aggressive but measured in their pursuit of reimbursement.\u00a0 Patients may be incentivized to hide their accident benefits from the hospital, as those benefits can pay to the patients directly.\u00a0\u00a0 If not careful, hospitals can spend time discovering and billing accident insurance only to receive little to no reimbursement.\u00a0 However, a hospital should also remember that MVA patients may have severe and\/or permanent injuries from their accident, giving them legitimate reasons to keep a large portion of their benefits.\u00a0\u00a0\u00a0 In the end, common courtesy should prevail to ensure that a hospital receives fair and reasonable reimbursement for its services without depriving the patient of funds needed to make them whole from their MVA injury.<\/p>\n","protected":false},"excerpt":{"rendered":"
By: Will Love, Director of Denials and Underpayments Over the previous five decades, motor vehicle accidents (MVAs) have increased emergency department (ED) visits in metro- area hospitals. While most MVAs cause minimal injury, injured motorists are lawfully entitled to a hospital visit, by ambulance if needed, following a car crash. With EDs daily treating MVA […]<\/p>\n","protected":false},"author":1,"featured_media":9248,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"content-type":"","om_disable_all_campaigns":false,"inline_featured_image":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[9],"tags":[],"acf":[],"yoast_head":"\n
[BLOG] Reimbursements for Motor Vehicle Accidents - Rise Family of Companies | Healthrise | Qodex | Agile<\/title>\n<meta name=\"description\" content=\"[BLOG] Reimbursements for Motor Vehicle Accidents Rise Family of Companies | Healthrise | Qodex | Agile\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"[BLOG] Reimbursements for Motor Vehicle Accidents - Rise Family of Companies | Healthrise | Qodex | Agile\" \/>\n<meta property=\"og:description\" content=\"[BLOG] Reimbursements for Motor Vehicle Accidents Rise Family of Companies | Healthrise | Qodex | Agile\" \/>\n<meta property=\"og:url\" content=\"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/\" \/>\n<meta property=\"og:site_name\" content=\"Rise Family of Companies | Healthrise | Qodex | Agile\" \/>\n<meta property=\"article:published_time\" content=\"2022-07-21T14:28:07+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-05-12T15:33:57+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/risefoc.com\/wp-content\/uploads\/2022\/07\/ER-visit-photo.jpeg\" \/>\n\t<meta property=\"og:image:width\" content=\"999\" \/>\n\t<meta property=\"og:image:height\" content=\"667\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/\"},\"author\":{\"name\":\"admin\",\"@id\":\"https:\/\/risefoc.com\/#\/schema\/person\/7f78ca75d5393c4a61bb9ea957f7f26b\"},\"headline\":\"[BLOG] Reimbursements for Motor Vehicle Accidents\",\"datePublished\":\"2022-07-21T14:28:07+00:00\",\"dateModified\":\"2023-05-12T15:33:57+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/\"},\"wordCount\":786,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/risefoc.com\/#organization\"},\"articleSection\":[\"Blog\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/\",\"url\":\"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/\",\"name\":\"[BLOG] Reimbursements for Motor Vehicle Accidents - Rise Family of Companies | Healthrise | Qodex | Agile\",\"isPartOf\":{\"@id\":\"https:\/\/risefoc.com\/#website\"},\"datePublished\":\"2022-07-21T14:28:07+00:00\",\"dateModified\":\"2023-05-12T15:33:57+00:00\",\"description\":\"[BLOG] Reimbursements for Motor Vehicle Accidents Rise Family of Companies | Healthrise | Qodex | Agile\",\"breadcrumb\":{\"@id\":\"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/risefoc.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"[BLOG] Reimbursements for Motor Vehicle Accidents\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/risefoc.com\/#website\",\"url\":\"https:\/\/risefoc.com\/\",\"name\":\"Rise Family of Companies | Healthrise | Qodex | Agile\",\"description\":\"We Are a True Healthcare Transformation Company\",\"publisher\":{\"@id\":\"https:\/\/risefoc.com\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/risefoc.com\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/risefoc.com\/#organization\",\"name\":\"Rise Family of Companies | Healthrise | Qodex | Agile\",\"url\":\"https:\/\/risefoc.com\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/risefoc.com\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/risefoc.com\/wp-content\/uploads\/2022\/02\/Rise-Logo1.svg\",\"contentUrl\":\"https:\/\/risefoc.com\/wp-content\/uploads\/2022\/02\/Rise-Logo1.svg\",\"width\":226,\"height\":90,\"caption\":\"Rise Family of Companies | Healthrise | Qodex | Agile\"},\"image\":{\"@id\":\"https:\/\/risefoc.com\/#\/schema\/logo\/image\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\/\/risefoc.com\/#\/schema\/person\/7f78ca75d5393c4a61bb9ea957f7f26b\",\"name\":\"admin\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/risefoc.com\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/736bbd9d1ada68c56fe59309d2fe8da5?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/736bbd9d1ada68c56fe59309d2fe8da5?s=96&d=mm&r=g\",\"caption\":\"admin\"},\"sameAs\":[\"https:\/\/risefoc.com\"],\"url\":\"https:\/\/risefoc.com\/author\/admin\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"[BLOG] Reimbursements for Motor Vehicle Accidents - Rise Family of Companies | Healthrise | Qodex | Agile","description":"[BLOG] Reimbursements for Motor Vehicle Accidents Rise Family of Companies | Healthrise | Qodex | Agile","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/","og_locale":"en_US","og_type":"article","og_title":"[BLOG] Reimbursements for Motor Vehicle Accidents - Rise Family of Companies | Healthrise | Qodex | Agile","og_description":"[BLOG] Reimbursements for Motor Vehicle Accidents Rise Family of Companies | Healthrise | Qodex | Agile","og_url":"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/","og_site_name":"Rise Family of Companies | Healthrise | Qodex | Agile","article_published_time":"2022-07-21T14:28:07+00:00","article_modified_time":"2023-05-12T15:33:57+00:00","og_image":[{"width":999,"height":667,"url":"https:\/\/risefoc.com\/wp-content\/uploads\/2022\/07\/ER-visit-photo.jpeg","type":"image\/jpeg"}],"author":"admin","twitter_card":"summary_large_image","twitter_misc":{"Written by":"admin","Est. reading time":"4 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/#article","isPartOf":{"@id":"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/"},"author":{"name":"admin","@id":"https:\/\/risefoc.com\/#\/schema\/person\/7f78ca75d5393c4a61bb9ea957f7f26b"},"headline":"[BLOG] Reimbursements for Motor Vehicle Accidents","datePublished":"2022-07-21T14:28:07+00:00","dateModified":"2023-05-12T15:33:57+00:00","mainEntityOfPage":{"@id":"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/"},"wordCount":786,"commentCount":0,"publisher":{"@id":"https:\/\/risefoc.com\/#organization"},"articleSection":["Blog"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/","url":"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/","name":"[BLOG] Reimbursements for Motor Vehicle Accidents - Rise Family of Companies | Healthrise | Qodex | Agile","isPartOf":{"@id":"https:\/\/risefoc.com\/#website"},"datePublished":"2022-07-21T14:28:07+00:00","dateModified":"2023-05-12T15:33:57+00:00","description":"[BLOG] Reimbursements for Motor Vehicle Accidents Rise Family of Companies | Healthrise | Qodex | Agile","breadcrumb":{"@id":"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/risefoc.com\/reimbursements-for-motor-vehicle-accidents\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/risefoc.com\/"},{"@type":"ListItem","position":2,"name":"[BLOG] Reimbursements for Motor Vehicle Accidents"}]},{"@type":"WebSite","@id":"https:\/\/risefoc.com\/#website","url":"https:\/\/risefoc.com\/","name":"Rise Family of Companies | Healthrise | Qodex | Agile","description":"We Are a True Healthcare Transformation Company","publisher":{"@id":"https:\/\/risefoc.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/risefoc.com\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/risefoc.com\/#organization","name":"Rise Family of Companies | Healthrise | Qodex | Agile","url":"https:\/\/risefoc.com\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/risefoc.com\/#\/schema\/logo\/image\/","url":"https:\/\/risefoc.com\/wp-content\/uploads\/2022\/02\/Rise-Logo1.svg","contentUrl":"https:\/\/risefoc.com\/wp-content\/uploads\/2022\/02\/Rise-Logo1.svg","width":226,"height":90,"caption":"Rise Family of Companies | Healthrise | Qodex | Agile"},"image":{"@id":"https:\/\/risefoc.com\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/risefoc.com\/#\/schema\/person\/7f78ca75d5393c4a61bb9ea957f7f26b","name":"admin","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/risefoc.com\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/736bbd9d1ada68c56fe59309d2fe8da5?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/736bbd9d1ada68c56fe59309d2fe8da5?s=96&d=mm&r=g","caption":"admin"},"sameAs":["https:\/\/risefoc.com"],"url":"https:\/\/risefoc.com\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/risefoc.com\/wp-json\/wp\/v2\/posts\/9247"}],"collection":[{"href":"https:\/\/risefoc.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/risefoc.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/risefoc.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/risefoc.com\/wp-json\/wp\/v2\/comments?post=9247"}],"version-history":[{"count":5,"href":"https:\/\/risefoc.com\/wp-json\/wp\/v2\/posts\/9247\/revisions"}],"predecessor-version":[{"id":9256,"href":"https:\/\/risefoc.com\/wp-json\/wp\/v2\/posts\/9247\/revisions\/9256"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/risefoc.com\/wp-json\/wp\/v2\/media\/9248"}],"wp:attachment":[{"href":"https:\/\/risefoc.com\/wp-json\/wp\/v2\/media?parent=9247"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/risefoc.com\/wp-json\/wp\/v2\/categories?post=9247"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/risefoc.com\/wp-json\/wp\/v2\/tags?post=9247"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
![\"\"](\"https:\/\/risefoc.com\/wp-content\/uploads\/2022\/07\/ER-visit-photo.jpeg\")
<\/p>\n