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Hi all--this is an odd request (at least, to me). I was out of state over the weekend at a conference and while crossing the street on my way to meet friends for dinner I was struck by a 14-passenger van. I was a pedestrian.
Anyway, I was told in the ER there not to drive or do any exercise or anything until seeing a doctor back home. I called my primary care doc and they do not do "third party billing" meaning they don't bill the driver' auto insurance, and apparently my health insurance will reject the claim b/c I was hit by a car, making it an auto insurance claim. Um, ok.
Anyway, I came here hoping someone has some knowledge of this and knows of a doctor who will see me and help me deal with the billing/process of this. Cary or Rex (Blue Ridge) area preferred.
Wow! I am so sorry. I hope you are ok? I am stunned that your health insurance won't cover you! I thought they covered us no matter what.
My experience with this comes from being in wreck (yrs ago) where a car ran a red light and hit my car. Normally by now you should have heard from their insurance co....have they given you approval to go ahead, see a doc and discussed how they'll reimburse you?
When this happened to me I didn't want my insurance co to have to pay for it and told the other person's insurance co I wanted them to take care of it right away. They beat around the bush but finally agreed to do this. They will say that they don't reimburse you until they settle, this can be worked around with insistence from you. At that time the rule was we had 3 yrs to settle, and during this time they had to pay for treatment if it is ongoing - this might still be the same.
It would be worth you consulting with an atty for 1/2 hr to learn your rights.
PS - sorry, forgot to answer your last question. 3rd party billing - IF they call a hospital or doc and send something saying they are responsible, then this should work anywhere. I think the way you posed your question dictated an immediate No.
Don't let them push you around, cost you money or time. There job is to settle it quickly for the least money possible. And be careful of any checks you deposit from them...read the back and materials carefully so you don't sign to say the case is settled in full.
Last edited by RaleighLass; 03-22-2010 at 10:55 AM..
Reason: ps
What a terrible experience you must have had. That is scary to go to an ER in a strange city.
First, I would also call YOUR insurance company and ask them what to do. It could be that your insurer will cover 'you' and then go after their insurance to get reimbursed. If that is the case, then your MD would not have to do anything different (and that is all they are really interested in hearing).
If you are not covered, then it might be worth a call the ER that you went to and ask what to do - whether you should go to the ER here (Rex) to get cleared for driving, etc.
You mention being at a conference...does that mean 'work time'? If you were there on a work sponsored event, then does workman's compensation *might* cover this or help you? Worth checking it out.
It still sounds like it might be worth consulting an attorney - because it sounds sticky. It might be a matter of having the local MD bill you and you turn it over to your attorney who gets it taken care of. You will want to be sure your ER bill is taken care of too. And if you have had to take any time off of work to get the MD clearance, etc taken care of.
Post and let us know what you find out so we can all learn from it.
Don't call the original ER. They were being PC probably due to the limited evaluation they did of you. Their advice was sound considering the circumstances. I really wouldn't bother them. They shouldn't be brought back into this. As WeLUv said, call your insurance co. But also do see an attny.
The insurance co when they make a settlement will say it covers your time off work, mileage to/from doc appt, pain and suffering, etc. This is why you need to talk with an atty to see what you need to be saying and recording at this time. You can handle your own case if you want, you just need to know your rights.
Have you heard from the insurance co for the driver?
I was in a car accident about 18 months ago. My health insurance at the time paid the claim with no problem. I've never heard of a medical insurer declining. Then I separately negotiated with the auto insurance company for payment for my medical expenses plus some. They did not direct pay any medical professional, and I would not have wanted to delay my care until they decided what they were going to pay. I didn't get a lawyer and in retrospect that was probably a mistake.
See a doctor, have them file with your regular medical insurance, then separately talk to a lawyer to help you with the medical claim against the driver's insurer.
I like Wake Internal Medicine and/or their affiliated urgent care, Rx Urgent Care. They are close to Rex and have x-ray facilities in the building.
THanks very much. I have contacted an atty in Kentucky where it happened--got their name from the BBB so hopefully they're good and honest, etc. I called the driver's insurance company, gave them the info, got a claim number, then ended up getting sent to the adjustor's voicemail.
The atty told me to find an orthopedist willing to testify to my injuries but I don't have a clue how to do that! The GP I am going to see say they will keep good records for the atty but that's about it. UGH.
I think had *I* been in a car this would've been easier maybe? But I was a pedestrian.
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