More than just the injured person has a claim to be paid at the end of a case. John Kluksdal discusses how the funds are distributed in our latest podcast.
Who Does Have a Claim That Must Be Paid?
When a case is settled or a judgment is recovered other people and entities must be paid from the funds received. For example, we represent our clients most of the time on a contingency fee basis. That means our clients don’t have any risk and don’t pay us unless we make a recovery. Then our attorney fee is a percentage of what’s recovered. Let’s say it’s $100,000 that’s recovered; then a percentage will go toward the attorney fee. But, there are other things that need to be paid as well including expenses like filing fees with the county, experts costs and deposition transcripts. In addition, there are often medical bills that have to be paid out of the recovery.
Why do I have to pay back health insurance?
If you are, for example, insured by Blue Cross your health insurance contract says something like, “We, Blue Cross, will pay your medical bills, but if someone else is found to be at fault for your medical bills, and you make a recovery against that person for your medical bills, then you have to pay us back.” This right to repayment language is found in most all health insurance contracts. If you are Medicare or Medicaid insured, then there’s a statute that says you have to pay them back, if you make a recovery. But in the end, we as Medical Lawyers Boise ID typically negotiate something with Medicare or Medicaid. Let’s say Medicare has paid $100 for a medical bill. They have to reduce that by a proportionate share of attorney fees and costs. Medicare, or Blue Cross, for that matter, shouldn’t be able to stick out their hand and say, “We paid $100. Give us $100.” They have to share proportionately with the client. So, for a dollar, if the client is paying 40 cents for attorney fees and costs, then Medicare gets paid 60 cents. Sometimes we negotiate with them even further. If the at-fault party has insurance limits, and it doesn’t cover all of your medical bills, then I talk to the health insurer and tell them there’s not enough money to go around. As a Attorney for Malpractice Lawsuit Idaho, I want them to take a reduction in fairness to my client.”
Why didn’t my hospital get the discount from my health insurance?
Sometimes the hospital bills the health insurer. Other times my clients have health insurance, for instance, and the hospital creates a lien against the case. They think they can get paid more by trying to come against the case, as opposed to taking whatever reductions health insurance requires. For instance, Blue Cross negotiates with the hospitals annually, and if they receive a $100 bill, they might have an agreement with the hospital that they pay $60. Medicare has statutory rates it’ll pay, and it typically pays even less than, for example, Blue Cross. So, the hospital not wanting to bill Blue Cross or Medicare is because they want to get paid $100 out of a $100 bill instead of $60 or $40.
Call Attorney John Kluksdal for a free consultation at (208) 343-7510
Medical Lawyer Boise ID
Attorney for Malpractice Lawsuit Idaho