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Steven M. Sweat, Personal Injury Lawyers, APC
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If you Have Health Insurance, how do the Medical Bills get Handled?

If you have health insurance including private health plans, Medicare, Medi-Cal, Covered California or any other health care program including “Obamacare” programs, the medical provider is required to bill insurance but, may demand that you pay any co-payment amount “co-pays” or meet a deductible. What payments are made or what you are required to pay directly as an individual varies depending upon the terms of your insurance policy or health plan. One of the major issues that come up is when a person is transported by an ambulance or treated at a facility that is “out of network” for their health plan. Other times, medical providers simply attempt to collect the full amount from the patient without ever attempting to bill their health insurance. Still other times, medical providers attempt to “balance bill” or “surprise bill” patients even though they have already been paid by health insurance at the contractual rate (a practice which is prohibited by California law but, still takes place too often). Even if the health insurance provider is billed and pays out money, the health insurance policy can (and often does) assert “subrogation rights”. This means that they can demand to be repaid all or part of what they paid out on your behalf if they find out that you will be recovering money from a third party (or that person’s auto insurance carrier).

If you Have “Medical Payments” Coverage With Your own Auto Insurance Policy

Many auto insurance policies in California have what is called Medical Payments coverage (or “med-pay”). This provides for payments of medical expenses up to a certain policy limit amount. It is usually a fairly low amount (most times less than $10,000) but, it certainly provides for another means to get the bills paid. Most (if not all) of these provisions also come with “subrogation rights” (or the right to claim reimbursement if you are awarded a settlement or judgment from the other party or their auto insurance carrier).

Medical Treatment on a Lien

Some medical providers (including quality specialists like Orthopedic Surgeons or licensed physical therapists) can and do agree to treat patients with no upfront charges but, an agreement to pay the medical bills out of the proceeds of a personal injury settlement. This may allow for a person with no health insurance or a health insurance provider unwilling to approve treatment, an option to get necessary medical care including therapy, possible surgery or procedures such as epidural injections and even medications based upon a written agreement to pay for these services at the time of settlement of their car accident case. You should keep in mind that these agreements usually require payment regardless of the outcome of the personal injury case. Also, most medical providers are not willing to enter into a treatment on a lien basis unless and until an attorney has referred the patient and verified the validity of their legal claims to recovery.

Client Reviews
I have known Steven for some time now and when his services were required he jumped in and took control of my cases. I had two and they were handled with the utmost professionalism and courtesy. He went the extra mile regardless of the bumps in the road. I can not see me using any other attorney and I would recommend him to any of my family and friends. Josie A.
Steven was vital during our most trying time. He was referred by a friend after an accident that involved a family member. While he was critical and lying in the hospital, Steven was kind, patient and knowledgeable about what we were going through. Following our loss, Steven became a tough and aggressive negotiator and made sure that we receive a huge compensation. I would refer Steven in fact, this happened 2 years ago and I still speak highly of his service. Cheryl S.
Mr. Sweat is a pitbull in the courtroom as well as settlement negotiations - You can't have a better equipped attorney in your corner! It is a pleasure working as colleagues together on numerous cases. He can get the job done. Jonathan K.
Because of Steven Sweat, my medical support was taken care of. Plus, I had more money to spare for my other bills. Steven is not only an excellent personal injury lawyer, providing the best legal advice, but also a professional lawyer who goes beyond his call of duty just to help his clients! He stood up for me and helped me get through the process. I would definitely recommend. I couldn't think of any better lawyer than him. MiraJane C.
I must tell anyone, if you need a great attorney, Steve sweat is the guy! I had an awful car accident and had no idea where to turn. He had so much to deal with because my accident was a 4 car pile up. Not to mention all the other cars were behind me and they were not wanting to settle in any way! He never stopped working for me and had my best interest at heart! Audra W.
I believe I made the best choice with Steven M Sweat, Personal Injury. I was very reluctant to go forward with my personal injury claim. I had a valid claim and I needed a professional attorney to handle it. I felt so much better when I let Steven take my case. His team did everything right and I am very satisfied. Stia P.
I have to say that Steve has been exemplary! I met Steve at a point with my case that I was ready to give up. He took the time and dealt with all of my concerns. Most importantly, he was present and listened to what I was going through. He was able to turn things around, put me and my case on the right track! The results were better that expected! Highly recommend!! Cody A.