Motor Vehicle Accident Claims

Day Zero Billing for Motor Vehicle Accident (MVA) Claims

The most common problem with patients how are involved in an automobile accident is that the billing team doesn’t understand how to handle the MVA insurance profiles and therefore the patient quickly gets moved into the “self-pay” bucket!  We see this almost universally!  In almost all instances, if the claims department understood the number of financial avenues to pursue they would find that coverage is available under an automobile insurance policy.  In some many instances the hospital, if persistent, can collect up to 100% of billed charges!  We recognize that MVA claims are usually on a few percent of the total revenue in any given hospital.  But our data shows that MVA is the very best payor on a pro-rata share basis when billing and collected properly!

First we must recognize that in many states MVA related insurance is primary to all other coverages.  In some states Workers Compensation preempts MVA.  Regardless of which state your hospital resides, MVA related auto insurance is always primary against governmental insurance.  This is actually excellent news for the hospital because MVA usually has a much higher reimbursement rate.

Second, a few states are STILL no fault states and use Personal Injury Protection Insurance as their primary insurance for automobile accident claims.  These claims are extremely difficult to maximize if your billing department does not understand how to force the PIP carriers to pay the bill in full.  We have experience in forcing this process to happen.  As incredible as it sounds, auto carriers have hidden medical payments insurance and only provided our clients PIP reimbursements and acted as if the claim was fully paid.  It is only after we have made legally sufficient demands for the medical payments insurance that the auto carrier relented and paid our clients tens of thousands of dollars in the auto carrier’s medical payment coverage!  This takes a lot of time, effort and specialized knowledge.  Unless you have attorneys in your office who are watching the PIP litigation in your state, it is literally impossible to keep up with the changes in PIP reimbursements on a State wide level.  GO-SB has those PIP attorneys in our office.  We watch the litigation as it proceeds through the court.  We are acutely aware of how to best maximize your hospital’s MVA revenue.  The final piece of the MVA puzzle deal with third party liens.  In some states these liens are referred to as Bodily Injury liens (BI Liens) in most places they are called a Letter of Protection (LOP).  If your hospital is accepting LOPs from the community of personal injury attorneys then you will need to have someone dedicated to following up on those outstanding balances. Further, your hospital will need a methodology to close those files during the pendency of the third party legal proceedings so that they don’t cause your AR days to go crazy high!  GO-SB has the right solutions to cover your bases and maximize your hospital’s MVA revenue without upsetting the delicate balance of AR days.

All you need to do is outsource MVA to GO-SB.

We will take all the MVA claims transferred to us electronically upon discharge.

We investigate each potential coverage related to the MVA, regardless if it is PIP, Medical Payments, Health, Government

We will put the first party auto carrier on notice and file any necessary liens to make future claims against either the first or third party payors.

We will make sure Medical Payments coverage is available or secured

We will make sure the PIP is secured and claims are being paid

We will secondary bill any Health Insurance

We will place any third party Auto Liability Insurance or Plaintiff attorney on notice that our hospital client has an outstanding claim.

We will file all appropriate liens

We will use our in-house attorneys to manage these claims appropriately without charging your hospital a legal fee.

We will secure and file all Letters of Protection in jurisdictions where Liens are prohibited.

If GO-SB determines that coverage is unavailable or exhausted, we coordinate benefits and obtain the verifications needed to secondary bill any available health or government insurance.