Personal Injury and MEDICARE: What you need to know about your claim.
Victims of personal injury due to auto accidents, premise liability or any other type of negligence, there are some serious hoops that need to be navigated in your claim. Many attorneys will be hesitant to take a case with a Medicare and/or Medicaid beneficiary. When dealing with a third-party payer such as Medicare, there are several important aspects of your claim that you should be aware of.
1.) Contact Medicaid or Medicare to Report the Accident Claim
Federal law requires that Medicare and/or Medicaid be notified of any accident that requires medical treatment. Often this is handled by a third-party, such as Xerox or Humana. Often it can be difficult to locate the precise Coordination of Benefits Contractor that holds your personal injury lien. When you contact them you must identify all medical facilities which you sought treatment and the names of any attorney handling your personal injury case. Failure to report a personal injury case may result in loss of future Medicare/Medicaid benefits.
2.) Medicare Reimbursements
After a settlement with the at-fault party is settled, Medicare requires that they be reimbursed prior to any release of funds to you or your attorney. This is often a sticking point with large personal injury firms and a reason they are hesitant to take cases from Medicare recipients. Medicare liens are typically non-negotiable and could wipe out a personal injury settlement if not handled correctly. It is in your best interest to request and carefully examine the COB Contractors list of medical bills. In some instances, an unrelated medical expense will be added to the personal injury claim. In those cases, you may need to call the COB Contactor and have them review your lien. If the Contractor does not agree with your disputed charges, you have the right to file an appeal.
3). Advantages of a Personal Injury Attorney vs. Representing Yourself
Medicare Reimbursements and liens may be handled by an individual who wishes to represent themselves, however this process is very intense and time consuming. It is very important to keep a log/record of every conversation and item of your claim. A Personal Injury Attorney who is familiar with this process is often the best way to go. Few attorneys will charge you for your injury suit up front, and will instead offer a contingency fee if/when you receive a settlement.
If you have been injured in an auto or premise liability and are a Medicare recipient, there are several things you need to know. At the Law Firm of Massey & Duffy, an experienced Personal Injury attorney will review your claim and assist you in dealing with insurance, Medicare, Medicaid and other third-party payers to ensure you receive the medical care and compensation that you deserve. Call our office today at (352) 505-8900 to schedule a FREE CONSULTATION.
