Are You Paying Too Much for Hospital Care? | Indianapolis Personal Injury, Car Accident Lawyers and Personal Injury Attorneys
This article defines the Hospital Charge Master—the mysterious menu of hospital prices for products and services. A link has been provided that allows you to compare prices for every participating Indiana hospital.
The Charge Master
Every hospital is responsible for setting their retail prices for the products and services they offer. Medical goods and services are priced and coded in an internal hospital database called a Charge Master. Since hospitals do not function as free-market competitors, hospital Charge Masters are veiled in secrecy in all but 13 states* where state law requires disclosure of Charge Master prices upon patient request. Although Indiana hospitals are not required to make their Charge Master public, the Indiana Hospital Association publishes an enlightening website that discloses certain hospital data provided to Centers for Medicare & Medicaid Services (CMS) and the Indiana State Department of Health including measures of care provided in each hospital, patient satisfaction, readmissions, infections, deaths, birthing outcomes and some basic hospital procedure charges. The Indiana Hospital Association’s website is a respectable first step toward public disclosure. But in light of a staggering disparity in hospital Charge Master rates and the perception that the deepest discounts are granted to the largest third-party payers, forces are pushing for greater transparency.
The Hospital Lien Statute | Ward & Ward Law Firm, Car Accident Lawyers
For example, Indiana’s Hospital Lien Act provides hospitals may file a lien for hospital charges against an action or claim brought by a patient against the parties responsible for their injuries. In Parkview Hospital v. Thomas E. Frost, Frost’s car accident lawyers alleged Parkview Hospital’s charges were unreasonable and requested Parkview Hospital provide information about discounts given to other patients with private health insurance and government healthcare reimbursement programs.
A recent opinion from the Indiana Court of Appeals stated:
“… evidence of discounts provided to patients who either have private health insurance or are covered by government healthcare reimbursement programs is relevant to the determination of reasonable charges under the [Indiana Hospital Lien] Act…”
Hospital costs and reimbursements
The Charge Master balances hospital costs, including inventory, staff, facility, insurance and permits with the less predictable estimate of account receivables from patients and third-party payers who reimburse hospital providers at diverse rates.
A hospital’s Charge Master for a procedure or product may be as little as 150% or as much as 1000% over Medicare, which reimburses only a small fraction of the Charge Master rate. Private and group health insurance providers contract separately with hospitals to discount the Charge Master rate by negotiating a Fee Schedule, a percentage of charges or by agreement of ‘usual, customary & reasonable fees’. Insurers generally reimburse at an amount greater than Medicare but substantially less than Charge Master. In an article written by Steven I. Weissman for the Florida Bar Journal, it is estimated that average Charge Master pricing at Florida’s hospitals would be 300% – 400% over the amount negotiated with major health insurance providers. Although Indiana hospital procedure rates may vary somewhat from Florida, the national trend toward deep discounts for government and contracting insurers remains the same.
Compensating for the reimbursement deficit
Automobile Insurers frequently pay hospital expenses resulting from an accident up to the policy limits of their clients’ Medical Payment automobile insurance coverage. Because Medical Payment insurance is considered primary to health insurance, hospitals bill auto insurance carriers the full Charge Master rate before balance-billing the patient’s health insurance—offsetting the deficit incurred from discounted health insurance and fractional Medicare reimbursements. *Note: Car accident lawyers would prefer patient’s health insurance pay the rate contracted between health insurance provider and the hospital.
Workman’s Compensation Insurance, out-of-network patients and uninsured patients are also billed Charge Master although out-of-network patients often pay a percentage of the Charge Master. Uninsured patients may qualify for free or reduced fee medical care.
Is there a better way?
In the last decade, we have seen some striking changes to the medical industry. But it can’t be overlooked that third-party payers have successfully exerted their influence to sustain the status quo. In a healthcare system that categorizes patients—favoring some, penalizing others—it’s of no surprise that the current structure of “reasonable charges” and “acceptable reimbursements” imposed on patient classes, is coming under scrutiny by a citizenry increasingly burdened by the high cost of health care, public servants, members of the legal community and medical professionals that would like to see a transparent and equitable hospital marketplace—one that implements predictability, consistency and fairness in hospital billing and discounts applied—all while maintaining quality hospital services indispensable to our communities and the well-being of our families.
Experienced car accident lawyers and personal injury attorneys
Our experienced personal injury attorneys and wrongful death lawyers use their knowledge of the law, legislation and judicial opinions to employ strategies that maximize our clients’ financial recovery after they have experienced a life-altering accident or event caused by another person or entity. If you or someone you know has been involved in an accident, injured by the negligence of a medical professional, or the victim of nursing home neglect or wrongful death, call car accident lawyers, Ward & Ward Law Firm, today at (888) 639-9501 for a free consultation.
Charlie WardWard & Ward Law Firm | Car Accident Lawyers 728 S Meridian St Indianapolis, IN 46225 317-639-9501 or 888-639-9501
Website recommendation: My Care Insight.
*Figure obtained as of this writing, June, 2016
Why Personal Injury Lawyers May Refuse Your Case – Uncollectability | Car Accident Lawyers, Auto Accident Attorneys, Ward & Ward Law Firm
Collectability is the ability to put money into the hands of an injured party and creditors who have extended treatment on their behalf resulting from an accident. It is an essential component of any personal injury claim. The following are examples of uncollectable claims frequently turned down by personal injury lawyers:
- Neither party has automobile insurance and the driver responsible for the injuries has no real or personal assets
- Liability cannot be ascertained through evidence or credible eyewitness testimony
- Damages are negligible and/or frivolous
- Injured party(ies) did not receive treatment immediately following the accident and did not follow up with a physician in a timely manner
It falls on you to protect your injured self from another person’s negligence | Indianapolis Car Accident Lawyers
The recession and suspended licenses have thrust an increase in uninsured drivers in Indiana. Of the approximately 4 million driver’s licenses issued in the state of Indiana, approximately 12% are suspended. According to the most recent estimate obtained by the Insurance Information Institute, approximately 1 in every 7 drivers or 14.2% take to the roads without any automobile insurance.
Uninsured/Underinsured Bodily Injury and Liability* coverage is included as a part of your policy unless you express in writing a desire to omit this coverage. UIM protects you, your family’s assets and financial exposure from reckless uninsured and underinsured drivers that may cause harm to you and others riding in your vehicle. Your uninsured coverage may also protect you from defendants fleeing a judgment through the protection of bankruptcy.
Experienced Indiana Car Accident Lawyers and Wrongful Death Attorneys
The personal injury and car accident lawyers of Ward & Ward Law Firm recommend increasing your insurance policy to reduce and protect your personal exposure in an accident you may or may not cause. A robust bodily injury and liability policy may cost only pennies a day more than the minimum policy required to drive in Indiana. Before you call an agent, learn more about automobile insurance coverage in Indiana at our attorney blog.
The auto accident attorneys at Ward & Ward Law Firm have more than 85 combined years of experience practicing personal injury, wrongful death and medical malpractice law. If you or someone you know has been involved in an accident, call personal injury lawyer, Charlie Ward, today at 317-639-9501 or toll free at 888-639-9501 for a free consultation.
Personal Injury Attorney
Preventing Pedestrian and Bicycle Accidents and Fatalities in Parking Lots | Indianapolis Pedestrian and Car Accident Lawyers
Statistics show that 1 out of every 5 auto accidents occurs in parking lots. The most common accident is a result of a vehicle reversing out of a parking space backing into another vehicle. Most of the damage to vehicles are minor. The real danger is when a vehicle reversing strikes a pedestrian or a bicyclists which can result in serious injuries or death.
Most injuries in parking lots involve children
Each year it is estimated by the National Highway Safety Traffic Administration (NHTSA) that approximately 200 fatalities and 15,000 injuries occur in back up accidents. Every week at least 50 children are struck in back up accidents and unfortunately 2 of those children are fatally injured. A majority of those children killed are under the age of 4.
Most, if not all accidents occur as a result of the child being in the driver’s blind spot. Today more people are driving larger vehicles such as sports utility vehicles, mini-vans and mid-sized trucks. As a result, the blind spots are larger in these types of vehicles.
In order to prevent or minimize these types of back up accidents, knowing the vehicles blind spots are paramount for safety. In addition, knowing your surrounding and parking defensively (i.e. pulling through a parking spot to exit going forward) is likely to reduce the risk of an accident.
Best Lawyers® and Car Accident Lawyers – Ward & Ward Law Firm -Experienced in Pedestrian and Bicycle Accidents Fatalities
The personal injury and car accident lawyers of Ward & Ward Law Firm have 85 years of experience handling pedestrian accident and wrongful death cases. If you or someone you know needs legal representation for their accident claim, call 317-639-9501 today and ask for “Charlie” for a free consultation.
By Charlie WardWard & Ward Law Firm, Car Accident Lawyers 728 S Meridian St Indianapolis, IN 46225 317-639-9501
Why personal injury lawyers may refuse your case – Failure to Mitigate Injuries | Indianapolis Car Accident Lawyers
An insurance policy is a contract between two parties, the insurer and the insured. Insurers expect an injured victim to seek medical treatment and obtain a diagnosis immediately following an accident or an injury caused by the negligence of another person or entity. Insurance companies view the failure to seek immediate medical attention as a failure to mitigate the damages. Why?
- An injured plaintiff has a duty and responsibility to receive a diagnosis and treat their injuries, thereby mitigating their injuries and other potential damages; and
- Absent a timely medical diagnosis, an insurance adjuster and claims panel cannot know what actions or activities the claimant has performed since the accident that may have acerbated the original injury.
In my law practice, I have learned injured victims often fail to follow-up with a physician soon after a collision. Some fear a doctor will order tests they are not prepared to pay, taking off from work may pose a problem and others do not want a disruption in their lives. They may self-diagnose, thinking the pain and discomfort will get better over time.
Men, in particular, may be reluctant to seek treatment or the advice of their physicians. The American Academy of Family Physicians found that 92% of men polled in an online survey conducted by Harris Interactive, waited a few days before seeking care. Nearly one-third wait “as long as possible” before they seek the care of a physician.
Delayed Symptoms and the Onset of Pain
Immediately following an accident, blood pressure and adrenalin levels surge. This triggers the hyperactivity of opioids in the brain, which may be responsible for the lack of tenderness and pain generally expected after an injury.
In an interview with The New York Times, Dr. Dennis Charney, a psychiatrist at Yale and director of clinical neuroscience at the National Center for Post-Traumatic Stress Disorder states:
“The opioid system of the brain, which can blunt the feeling of pain, is hyperactive…For the brain changes to occur, scientists now say, people usually have to experience the stress as catastrophic, an overwhelming threat to life or safety and one over which they [have] no control… It does not matter if it was…a one-time experience, like being trapped in a hurricane or almost dying in an auto accident…All uncontrollable stress can have the same biological impact.”
When the brain’s chemistry finally returns to the patient’s baseline, varying degrees of discomfort may be experienced. Pain is an indicator that something unusual is occurring in the body. It may be an indication of inflammation or a precursor to a heart attack―but it should never be ignored. If you or someone you know has been involved in an accident, our attorneys recommend you consult with a physician as soon as possible after the collision or injury. Many attorneys will refuse to file a claim if the injured person has delayed diagnosis and treatment.
Experienced personal injury attorneys and car accident lawyers in Indianapolis
The car accident lawyers and personal injury attorneys at Ward & Ward Law Firm have more than 85 combined years of experience practicing personal injury, wrongful death and medical malpractice law. Call personal injury lawyer, Charlie Ward, today at 317-639-9501 or toll free at 888-639-9501 for a free consultation.
Learn about Indiana’s RAP Clause
Unjust Law Strengthened Aspirations of 2015 Legendary Personal Injury Lawyer | Car Accident Lawyers and Personal Injury Attorneys
When Indiana personal injury attorney, Donald W. Ward, was a first year law student, he learned through personal experience that “a lot of injustices have been legislatively induced.” To counter the power structure favoring insurance companies and special interests, the former President of the Indiana Trial Lawyers Association has worked alongside like-minded, dedicated trial lawyers with members of the Indiana General Assembly to amend and pass legislation that would protect the trial court “wins” for injured clients.
Ward recalls one peculiar aspect of the Indiana Guest Statute that directly influenced his professional aspirations. During the fifties and prior to its amendment in 1998, the Indiana Guest Statute favored insurance companies by preventing an injured or deceased passenger from filing suit against a negligent owner or operator of the vehicle in which they were riding, except under narrowly defined circumstances. “Because you were a guest in my car,” Ward said, “my negligent driving did not entitle you to sue me for injuries caused by my negligent driving unless you could prove that I willfully or wantonly ran that red light.” Willful intent was key to overcoming the restrictions of the unjust law.
The early Guest Statute personally affected the Notre Dame Law Student
Jurisprudence was Ward’s calling. But it became personal after his sixteen-year old sister sustained life-threatening injuries when the vehicle in which she was riding crashed due to driver’s negligence. Upon learning of her accident and the injuries she suffered, he immediately left the law school he was attending to take his place with the family alongside her bed.
While in a prolonged state of unconsciousness, witnesses to the crash misled authorities by withholding facts. There was little hope her body could survive the excessive traumas and because of the restrictions placed in Indiana’s Guest Statute, little expectation that the driver’s insurance company would be financially accountable for the mounting medical bills.
Sometime later―her jaw wired shut―she awoke from a comatose state. When she finally regained the ability to form words, she stunned family members when she communicated to them that the driver of the vehicle in which she was riding had been drag racing on the road leading into the small town of Osgood when the accident occurred. She further articulated that prior to the crash, she and other passengers in the car firmly told the driver to “slow down.” Although latent, the adolescent eyewitnesses eventually corroborated the illuminating statement made from the hospital bed.
When the authorities determined the cause of the accident; that the driver of the car had “willfully” engaged in risky driving behavior; and the victim’s request to “slow down” had gone unheeded, this was the break family attorney and Ward’s mentor needed to proceed with a claim that would fall within the strict interpretation of the law. This incident and the bond formed between Ward and the late Howard S. Young Jr., served to strengthen Ward’s resolve to become a practicing plaintiff’s lawyer and to use his skills to affect changes in laws that were unjust and denied citizens equal access to trial by jury.
Former President of the Indiana Trial Lawyers Association
Since those days back in the fifties, members of the Indiana Trial Lawyer Association have worked diligently to protect the rights of Hoosier citizens in the legislative process. Ward says, “It is my belief that the voices of individual citizens are heard in the legislative process through the members of the Indiana Trial Lawyers Association.” When asked about his career as a trial lawyer, he said “The law profession is a very noble profession and I am very proud to have been a small part of it.”
Indiana’s Guest Statute, also known as the “Hitchhiker’s Law,” was eventually amended and implemented in 1998 reducing its scope to include parents, spouses, children, stepchildren, siblings, and hitchhikers. To learn more about the current Guest Statute in Indiana, visit the Ward & Ward Law Firm blog.
On August 19, 2015, Donald W. Ward of Ward & Ward Law Firm in Indianapolis, received the 2015 Legendary Lawyer Award presented by the Indiana Bar Foundation, a charity comprised of lawyers and judges who are dedicated to strengthening access to justice and an appreciation for the rule of law in Indiana. The committee that selected Ward was composed of Bar Foundation Fellows practicing law across the state of Indiana. Today, Ward is a diligent advocate for his firm’s injured clients and the families of wrongful death victims. Ward says he has no intention of retiring and will continue his work as a practicing personal injury lawyer.
Experienced Indianapolis Personal Injury Attorneys and Car Accident Lawyers
If you, or someone you know, has been injured in an accident, call personal injury attorneys and car accident lawyers, Don and Charlie Ward, today at 317-639-9501 or 888-639-9501 for an evaluation of your claim.Ward & Ward Law Firm Car Accident Lawyers and Personal Injury Attorneys 728 S Meridian St Indianapolis, IN 46225 317-639-9501 888-639-9501