Personal Injury: What Are Hard vs. Soft Bills?

In the world of personal injury, medical bills drive settlements. The higher your medical bills the larger your final settlement figure. That is, unless you have the wrong kind of bills. Hard bills pay, soft bills do not.

Hard Bills

  • Ambulance

  • Emergency room visit / emergency room physician

  • Diagnostics ordered by a medical doctor (MRIs, CTs, X-rays, EKGs, etc.)

  • Specialists

  • Surgery and related bills (hospital, surgeon, diagnostics, medication)

  • Primary care physician

  • Physical therapy (more than 6-8 weeks starts to become questionable)

  • Prescribed medication

Soft Bills

  • Chiropractor

  • Massage therapist

  • Acupuncturist

 

Other Things To Consider

 

Delayed Treatment / Gap In Treatment

Following an accident, waiting as little as 3-5 days before going to the doctor creates real problems for your case. Why? People will be skeptical about the extent of your injury. After all, you were able to wait five days before you saw a doctor. In addition, you could have injured yourself during those 3-5 days and are now trying to get someone else to pay your bills. In reality, people wait to seek treatment for a host of reasons, none of which have anything to do with the severity of their injury. In fact, some very serious injuries do not present right away. 

A more common problem is "Gap In Treatment." After visiting the ER or your primary care physician, it is vital you continue regular visits. Depending on your recommended course of treatment, allowing more than a few weeks between appointments is bad. Adjusters, defense lawyers, and juries like to use a gap in treatment to indicate when treatment should have ended. For example:

Following an accident you treat for one year. You incur $110,000 in bills. From month 3-4 you do not go to physical therapy (work, kids, exhaustion, etc.). During settlement negotiations, the insurance adjuster will only pay for the first two months of treatment citing a gap in treatment. Not only is your settlement reduced by 60-70%, but guess who is responsible for those outstanding medical bills from month 4-12? You! And because of timely filing rules, it is may be too late to submit them to your health insurance. 

 

Soft Bills, What's Wrong With Chiropractors and Eastern Medicine?

There is nothing wrong with chiropractors nor Eastern medicine. There is credible research that chiropractic and acupuncture care can aid in repairing lower back injuries and help with blood flow (a necessary part of the healing process). However, when it comes time to negotiate with insurance adjusters, extensive chiropractor bills are generally ignored. Victims can expect to get less than 20-30% of their chiropractic and related bills reimbursed. The severity of their injury will also come into question. Compare this with an ambulance or ER bill that gets reimbursed at 90-100% and drives up pain and suffering totals.

 

The Takeaway

Take an ambulance from the scene if possible. Otherwise, see a doctor the same day as your accident (early the next day at the latest). Once your treatment starts, do not miss appointments and do not allow more than 1-2 weeks between treatments (unless ordered by a doctor).

Get a prescription for physical therapy instead of seeing a chiropractor. If you do see a chiropractor, try to bill through your health insurance and anticipate having to pay those bills yourself.

 

Injured and want to know more? Use the links at the bottom of the page to call, text, or email me.