MEDICAL DEBT – LAWYER NEGOTIATIONS AND SETTLEMENTS

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Medical Bill Attorney Negotiating and Settling Hospital Debt and Doctor Bills

• Types of Medical Debt
• What’s Unique About Medical Debt
• The Resolutions Available to Resolve Medical Debts
• Disputed vs. Non-Disputed Medical Debts
• Third Parties Potentially Covering Medical Debt
• Negotiation Options for Medical Debt
• Bankruptcy Options for Medical Debt
• Litigation Options for Medical Debt
• Why Use Our Law Office to Help Resolve Medical Debt

Types of Medical Debt

There are several types of medical debts: doctor bills, hospital bills, emergency care bills, nursing home bills, home health aid bills etc. which can be a burden to a person on a fixed income or unable to work. Often these medical bills are mostly covered by insurance or another form of third party coverage, a government program or form of reimbursement. But when medical bills are not covered they can be an enormous burden on persons whose income and savings are often unable to absorb the large, new and unexpected debt.

Besides the question of whether a medical bill was or was not covered by insurance or by another third party, there is the question as to whether the medical bill is disputed or not disputed. To the extent that there is potential coverage or a potential dispute for a medical debt, it makes the pursuit of the debt by the creditor, more defendable by the medical debt debtor.

What’s Unique About Medical Debt

What’s unique about medical debt compared to other debt is that the debt is usually not by choice but usually incurred out of necessity. Often there are medical emergencies or exigencies involved that dictate the incurrence of the debt. Given that the debt (if not covered) is usually high and that the potential client is often in a compromised health situation, there need to be options that we can review that help deal with this kind of asymmetrical debt situation where the debt often can be high and the ability of the medical debtor to pay is often low.

What is also unique about medical debt is the complexity surrounding the contract for services that occurs when a patient is admitted. Often the person signing the patient in when there is an emergency is a family member; often the debtor is on another’s policy. There are often questions later as to who signed for the medical service, who’s insurance was used, whether the patient was competent and should be billed especially if mistakes/errors where made in admitting/treating the patient. The question is often who is liable? And if so for what are they liable?

The Resolutions Available to Resolve Medical Debts

As with other areas there are many possible ways to resolve medical debt as follows:

1. Lump sum settlements – that significantly lower the amount owed in return for quicker payment.
2. Installment payment plans – that spread the debt out over time to make monthly payments affordable but do not reduce the overall debt as much given that the payment plan may span a relative longer time.
3. An assignment of the third party claim or the the insurance claim – often the medical provider will take the responsibility to collect the debt from the insurance policy and will in return for the assignment forgive any deductible.
4. A Mutual Release by Both Parties – where the medical services had problems/issues and potentially flawed results the medical provider may forgive the fees/costs in return for a release from any malpractice claim.
5. A Lien on a Law Suit or Other Pending Method of Reimbursement – Especially where the patient claims harm because of a a third party’s actions that was the cause of their medical bill, the medical care provider may lien the law suit in anticipation for payment when it settles.
6. Medical Expenses Covered by a Good Samaritan or Government Program – Especially where the medical services provided are a sympathetic or life threatening conditions there are charities and grants that can step in a cover either partially or fully the care or alternatively Government Programs may find it in their budget to fund the care.

However the medical debt is resolved depends highly on the facts: the type and cost of the care and the medical issue, the resources of the patient, the resources of the medical provider and/or whether there is a third party insurer of fund available to fully or partially cover the care.

Disputed vs. Non-Disputed Medical Debts

What is unique to medical debts compared to other areas of debt are as follows:

1. Liability/ Competency – Is the debtor liable for the debt where the initial competency of the patient can be disputed.
2. What was the Contract? – A potential patient does not know initially the extent and nature of the care he/she is given. The question is to what extent was a contract formed when there is lack of information/knowledge.
3. Duress? Lack of Bargaining Power? – To the extent there is a potential emergency, the patient/debtor may not be able to think clearly and may later feel and/or claim duress or misinformation, especially if there was no emergency and it later turns out the medical services were expensive but not needed.
4. Third Party Coverage/ Reimbursement – Often the patient/debtor is expecting the care to be covered and may be surprised to find out that they are not fully covered. Even the deductible for certain procedures could be high.
5. Lack of Means / Destitute Patient – Often the patient/debtor lacks means and is destitute. To what extent do they owe debt that they would never be able to repay?
6. Botched Medical Services / Malpractice – To the extent it could be claimed that the medical services were full of mistakes and did not help the debtor/patient, but were costly for the hospital/doctor, is there still liability? But this possible scenario could be worse, the medical services could not just be discovered to have been unnecessary, but they could have caused harm and be the subject of a malpractice claim. In such a situation the debtor/patient would claim that it is the medical provider that would need to provide payment and not the other way around.

The above issues can help us negotiate a medical debt for a client, based on the possibility of a litigation that we can defend. But these issues also are issues that we can raise in a litigation, as defenses or counterclaims.

Third Parties Potentially Covering Medical Debt

The are many possible third parties covering medical debt: private health insurance plans, other private insurance (vehicular insurance, disability insurance etc), government programs like Medicare, Medicaid, Medical Services to Veterans and Public Employees, Worker’s Compensation. In addition there are benefits carried by Unions, Professional Associations and religious organizations for their members. Finally there are a host of private charities, foundations and government programs that cover certain medical debt.

Despite the above often the patient/ medical debtor is left with significant medical debt if they had any serious medical procedure. The deductible alone can be considerable. In such a situation the options below may help in terms of negotiation, bankruptcy and litigation options for medical debt.

Negotiation Options for Medical Debt

Often the medical provider enlists a collection agency or attorney to collect on the debt. They know that they need to seek some sort of negotiated resolution on behalf of their client and will be open for offers assuming they are made in a realistic and respectful manner. They realize that the debtors/patients are in sympathetic situations and pursue the debt out of necessity. We are able to get our clients better negotiated resolutions since we are known as a bankruptcy law office that can help the client totally discharge (eliminate) the debt. If there are available deals, we will usually be able to get the best terms.

Bankruptcy Options for Medical Debt

Chapter 7 of the Bankruptcy Code totally eliminates debt. But given a debtors income and assets not every medical debtor can or wants to file in Chapter 7. Therefore there are reorganizations under Chapter 13 and 11 which can allow the payment of the medical debt over time and at a percentage of what is owed. While these may be the most powerful solutions, not every medical debt justifies a bankruptcy filing and often negotiations or litigation are more appropriate.

Litigation Options for Medical Debt

Medical Debt is rife with opportunities for defending a litigation. The issues raised above as to Disputed Medical Debt provide ample issues to litigate: whether a contract was formed, competency, liability, informed consent, duress, quality of services, value of services etc. These issues can help a medical debtor litigate and/or negotiate a better resolution of their medical debt. In certain situations the medical provider’s care and procedures may cause them to be vulnerable to a cross-claim that may help a resolution of the debt.

Why Use Our Law Office to Help Resolve Medical Debt

The Law Office of Ronald D. Weiss P.C. concentrates in resolving medical debt and often can achieve the best possible resolution of the medical debt given its ability to employ various tools and potential tools to deal with the debt: negotiation, litigation and/or bankruptcy. Each one of these tools has further options that we can employ and often we use more than one tool to resolve a debt. Where one option does not yield the hoped for results, another option may do so. Because, as stated above, medical debt is unique, it is important to be legally represented.

Please call us at 631-271-3737 for a free consultation as to how we can help you with your medical debt.