Chiropractors have contacted our office lately with concerns relating to their ability to receive payments under a patient’s medical pay coverage of an automobile insurance policy. As most doctors are aware, many automobile policies contain “med pay” provisions which provide coverage for the health care treatment provided to an insured under the policy. The insurerd commonly includes any passengers in an automobile involved in an accident. Treating chiropractors should always question a patient to determine if this type is coverage is available since the limits of the med pay is typically paid without the types of challenges or discounts often made to coverage proveded by a health insurer.
Some doctors have noticed recently that attorneys representing patients have unilaterally “invaded” the payment process by either advising the med pay insurer to pay the patient/attorney the limits of coverage or redirect all payments to a provider other than the chiropractor. Although payments are usually made to whichever proviider first provides the care and submits a claim, many policies have been interpreted by attorneys as allowing the patient to control and manage the amount of coverage available to them. There have even been situations where the attorney has expressly told the insurer not to pay the treating chiropractor.
There are various fianancial reasons why attorneys may seek to control the payment of med pay benefits. Without discussing those reasons in this blog, there is a viable technique available to the chiropractor to preempt this type of conduct. The technique focuses on examining the office’s assignment of benefits/claim form commonly signed by the patient to insure that an important provision is included in the form.
The goal is to insure that the form expressly indicates that the assignment of insurance benefits authorized by the patient is irrevocable. We have suggested the addition of basic language such as: “This assignment of benefits shall not be rescinded or revoked by myself, my attorney, and/or anyone who claims to represent me now or in the future.” Although the patient could arguable rescind the assignment by terminating the doctors care, this language should be enforceable for a long enough period to insure that much, if not all, of the med payment benefits are paid to the patient’s doctor.
The language could be expanded to “expressly instruct that the payment of medical payments not be rediredted to the patient or patient’s legal counsel”. In either situation, the doctor can further protect their right to recieve benefits by sending a copy of the assignment form to the insurer with the initial claim form. The cover letter should ask that the insurer contact the doctor’s office if there is any attempt by the patient or their legal representative to redirect or rescind the medical payments. By considering the additon of this simple language to the assignment of benefits form, the treating doctor can add some assurance that the medical pay coverage is going to the party who has earned the payments – the treating doctor providing for the necessary care for the injured insured under the policy.
COMMUNITY.