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Albuquerque Injury Victim Benefits: Save Medical Costs and Avoid Debt

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One of the most important, yet often misunderstood, parts of a personal injury claim are the accident victim’s potential to create debt in their case. This, after all, is why it is so important for accident victims to have their medical bills paid for by health insurance after suffering catastrophic injuries. The best catastrophic injury lawyer in Albuquerque should helpfully remind accident victims that a large payout that must be used to pay off significant medical bills defeats the purpose of making victims whole after a serious New Mexico accident.

To this end, here are helpful reminders for saving on medical costs and avoiding debt with the help of a catastrophic injury lawyer after an accident:

Make Sure your Health Insurance Company Pays, First and Foremost

If you have been injured in a catastrophic accident and have health insurance, make sure that health insurance is paying for your medical bills. If you are in search of Albuquerque’s best catastrophic injury lawyer for your legal claim, know that an attorney who provides this reminder demonstrates a genuine concern for your financial well being.

A catastrophic injury lawyer and attorney who lets you navigate this process without reliable counsel concerning avoidable pitfalls are making a mistake that actively increases the likelihood you will make a financial error. To help accident victims avoid making a poor decision when medical bills must be paid, I often advise clients to only provide health insurance to a healthcare provider and hire a catastrophic injury lawyer.

Don’t Provide Your Auto Insurance or the Other Driver’s Auto Insurance to Your Healthcare Provider

This best practice is rooted in existing New Mexico personal injury law, which currently stipulates an injured party claims the face value or retail value of incurred medical bills after an accident. However, your health insurance likely utilizes a “provider discount”, meaning that far less is paid to the healthcare provider after their bills are submitted to and paid by health insurance.

By only providing health insurance, you can ensure that your health insurance properly processes and pays the bills (do make sure this process is completed). Once this process is completed, I will then contact your insurer to obtain lien information concerning what the health insurance company has actually paid toward your bills and medical care. When your case is settled or you receive a favorable verdict at trial, I then can typically negotiate a further reduction of the health insurer’s lien to maximize the recovery to my clients.

Directed or Referred Care has the Most Credibility with Auto Insurers

One of the areas that a person can create debt on their case is by responding to a solicitation from a medical provider or selecting a health provider on their own that does not accept their health insurance. If your health insurance is not paying for medical care you are receiving, then you are creating debt that will need to be paid back by you regardless of the strength of your claims or the outcome of your case. If health insurance pays, they only have a lien on your case if you get money from the other person’s auto insurance or your own auto insurance if you have an uninsured motorist claim. This is not true if you incur medical bills that are not paid by health insurance because these providers are waiting for payment and will expect to be paid back in full regardless of whether you win or lose.

For example, if a client receives $10,000 in medical care that is paid by their health insurance, the health insurer may pay as little as 50% of the billed amount or $5,000 under this example. I then get in touch with the health insurer and hopefully negotiate a reduction of their hypothetical $5,000 lien and the payback would be approximately $3,100 with the two rounds of reductions that the medical bills will typically undergo when health insurance pays. If your bills are not being paid by health insurance, you will owe the medical provider the full $10,000.00 and medical providers that wait for payment usually do not make reductions. There are also differences in the way auto insurance companies review medical care that has been referred by a medical doctor or your primary care physician as opposed to caring that you self-selected. At trial, you will need to prove that the medical care you received was medically necessary as a result of the collision and that the medical bills are reasonable for providers in Bernalillo County. When your primary care physician is making referrals to other medical providers, the auto insurance company knows that the care was medically necessary as a result of the written referral. If you self-select a provider, the insurance company then usually makes the argument that the care was not medically necessary because no doctor told you to go.

Save your Medical Payments Coverage for Yourself

If you have purchased medical payments coverage, save this coverage to help you pay for your out of pocket expenses such as co-pays for your health insurance and prescriptions. If you notify medical providers that you have medical payments coverage then they will first bill medical payments coverage in full in hopes that they will be paid 100% of their bill out of the medical payments coverage and not be forced to take the discount that health insurance will require them to take if they bill your health insurance. This then usually creates massive billing problems down the line with serious or catastrophic injuries because the medical providers start sending everything to medical payments coverage instead of health insurance. Medical payments coverage is usually purchased from your automobile carrier in smaller amounts in limited coverage such as $1,000 to 5,000. This is not included in what most people consider “full coverage” which typically applies to the property damage claim. Even if all of the providers have exhausted medical payment coverage up to the limit, they keep sending their bills to medical payments coverage because the account is set up to bill med pay and not health insurance. After sending repeated requests, the time period to file with your health insurance may have already expired and the medical provider then sends their bill to a collection and it starts damaging your credit when you had health insurance and were entitled to use it.

Remember, if you purchased health insurance, you are entitled to use it and you are entitled to the discounts that your health insurance provides. Over and over again it is proven on the cases that I handle that the client’s net recovery when health insurance pays their bills is substantially larger.

Albuquerque New Mexico Catastrophic Injury Lawyer

I am happy to discuss your catastrophic injury case with you in detail with zero pressure. I welcome the opportunity to give you information about your case as well as be considered to represent you.




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Pofahl Law Firm went above and beyond for me. I appreciate everything the team has done for me! Thank you!


Mr. Pofahl and his team pushed for me to get what I deserved. I appreciate the firm line of communication with updates, going above and beyond for me. Thank you all for everything!

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By Lisa Littlepage

By Lisa Littlepage

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