Improper Hospital Billing Practices After Injury Accident

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Hospital billing practices after a personal injury accident is something that most accident victims aren’t thinking about. In the aftermath of an injury accident, a million things cross your mind. You’re worried about your physical well being and recovery. You must also think about holding the responsible party accountable and getting the financial recovery that you deserve.

In the midst of it all, another thing to be aware of is the hospital billing practices after your accident. You have the right to have your treatment providers charge you for their services fairly and appropriately. If you’re overcharged, your financial recovery from your legal claim may come up short. In addition, hospital billing practices are a matter of justice and fairness for a victim after an injury accident. Our Las Vegas personal injury attorneys explain.


    Illegal Hospital Billing After an Accident

    Illegal hospital billing after an accident can take many forms. For example, the hospital may charge you administrative fees that don’t have meaning. They may charge you for services you never received, or they may provide you with medical care that you don’t need. Illegal hospital billing after an accident is a way that people are victimized for a second time. However, you can fight back to challenge illegal hospital billing and receive fair treatment when you’re hurt.


    Here are some of the ways that hospitals engage in illegal billing practices after a personal injury accident:

    Not Using the Discounted Rate Negotiated by the Insurance Company

    Each insurance company negotiates directly with the hospital for special rates. The hospital has the sticker price for each service, but then they negotiate for better rates directly with the insurance providers.

    Sometimes, the negotiated rate is less than half the sticker price or even more discounted than that. If you have insurance, the hospital has to use the discounted negotiated rate when they bill for your care. Failing to use that rate ultimately passes on an unfair and unauthorized bill to you, the victim.

    Intentionally Billing Services Not Covered by Insurance

    The hospital knows what services are covered by your insurance. Sometimes, they intentionally provide services that aren’t going to be covered. Then, they demand that you pay for this care out of pocket without help from your insurance.

    In addition, sometimes they purposefully use a particular billing code to identify the care that you received, when they know that billing code isn’t going to be covered by insurance. Intentionally billing for services not covered by insurance is a form of bad hospital billing practice after a personal injury accident.

    Using Billing Codes for Services More Complex Than the Services Rendered

    An easy way for the hospital to engage in improper billing is to bill for greater complexity services than the care that you actually receive. For example, if you have a five-minute, simple doctor’s check-up, they might charge for an involved, invasive visit.

    Hospitals have all kinds of ways to manipulate billing practices slightly to make it seem like care is more invasive and complicated than it actually is. It can take a great deal of sleuthing to uncover the truth. Nerd Wallet has a great guide to reading medical bills for more information.

    Incorrect Reporting of Diagnosis to Make a False Claim of Medical Necessity

    Sometimes, hospitals engage in fraudulent billing practices by incorrectly reporting a diagnosis. To have an insurance company cover any procedure or type of care, the care must be medically necessary based on your diagnosis. The hospital might make incorrect statements or inflate the severity of your condition to make a false claim of medical necessity.


    A hospital may simply overcharge you. When you’re hurt in a personal injury accident, you need immediate care. The hospital knows that you’re not in a position to ask questions. The hospital may charge you too much in the hopes that you’re distracted or not paying enough attention to notice the overcharges. Overcharging is a form of fraudulent hospital billing practices after a personal injury accident.

    Corruption, Kickbacks, and Bribes

    Some forms of poor hospital billing practices are more overt. Sometimes, insiders in the hospitals and insurance companies coordinate corruption like kickbacks and bribes in exchange for overbilling. Kickbacks and bribes can be hard to prove, but if you can, use the legal system to formally gather evidence and summon witnesses to testify under oath.

    Mysterious Fees That Are Unrelated to Care

    When you’re being treated for a personal injury accident, beware of mysterious fees. The hospital may attach miscellaneous fees to your bill. There may not even really be an explanation for what the fees are, what they cover, and whether they’re legitimate. Don’t be afraid to ask questions if you see fees on your hospital bill.

    Can You Sue a Hospital for False Billing?

    Yes, you can sue a hospital for false billing. First, there are a series of internal challenges and appeals that you can undergo with the hospital. If there is an insurance company involved, they can be included in appeals as well.

    Actually, when a hospital commits false billing, it’s up to them to convince a court to issue a legal judgment against you if they want to collect payment. However, if they bring an action, you must be prepared to fight back. Through direct negotiations and a lawsuit, you can sue a hospital for false billing.

    Contact Our Personal Injury Lawyers If You Suspect Improper Hospital Billing After Your Accident

    Our injury accident attorneys are available to talk to you about your case. If you suspect fraudulent or improper billing, let our experts investigate on your behalf. If there is improper billing in your case, we’re prepared to help you handle it in the best manner possible. We’re prepared to take the hospital to task and challenge improper billing. We’re not afraid to make your case in court.

    Don’t be a victim twice. We’re prepared to fight for justice for you. Call our personal injury lawyers today so that we can begin working immediately on your case.

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