What is Third Party billing?
Third Party billing includes all available medical billing options for car accident injuries. Auto insurance is the most commonly used coverage for auto accident injuries. However, there are several other options for car wreck injuries including PIP, NO Fault, Med Pay and Letters of Protection (LOP) from an attorney. Third Party billing generally provides medical care after a car accident with no out-of-pocket expense. If you have been injured in a car accident, you may be eligible for Third Party Billing coverage. However, many Medical or Family Doctors will not accept third party billing. They only want to take first party billing or be paid up front.
Third party vs First Party billing in an auto accident
First Party Billing
First party billing would be through your own auto insurance company such as Geico or Progressive. This would also include Med pay or PIP (personal injury protection). The medical doctor, physical therapist or chiropractor would contact your insurance company directly and bill them accordingly.
If medical care exceeds the amount of the insurance coverage, the Doctor would be forced to work on a medical lien, also known as an LOP. However, the insurance company has no obligation to pay for medical care exceeding the benefit amount. At that point, in any medical costs over the benefit amount may become part of a personal injury case against the third-party insurance company.
Third Party Billing
Third party billing for car accidents means that you are covered by the at fault party’s insurance company. This type of coverage generally includes medical treatment on a lien from the medical provider. They will get reimbursed at the end of the settlement process, or when you sign your personal injury claim. As an additional option, injured victims can choose to pay for medical care out-of-pocket and gather the medical bills to submit for reimbursement after they have healed from their injuries.
In most cases, Doctors who provide accident injury care will work on medical liens or Auto Insurance. Furthermore, car accident patients will not pay any out-of-pocket expense. In most cases, the third-party insurance company will not pay for medical care up front. However, any medical costs incurred will be covered when you sign your personal injury claim. Third party billing oftentimes takes the longest for the doctor to recover medical expenses rendered.
If you have Med-Pay or PIP, the insurance company is only required to pay for reasonable or necessary medical care. This means that the Accident Doctor must follow the generally accepted guidelines for treating auto injury cases. Therefore, the Doctor is forced to charge a fair amount or the insurance company could deny the claim.
Understand what kind of insurance you have
Some people have never heard of Med Pay or PIP until after an accident. Know what kind of insurance you have and what it covers before you are involved in a car accident. Don’t wait until you are injured and needing immediate help. Med Pay can help supplement your medical expenses if you are injured. And, you are covered up to the amount that you specify at minimal costs. You do not have to rely on third party insurance to cover your medical expenses after a serious car accident.
Most insurance agents will not mention Med Pay because they are not incentivized or paid a commission to offer these plans. Contact your auto insurance provider for more information about Med Pay. You may be discouraged from purchasing Med Pay at first. Again, your Agent is not paid when you buy additional Med Pay insurance. Your Agent will most likely steer you towards additional coverage before offering Med Pay options.
Doctors who do third party billing in auto accidents
A Doctor who is willing to do third part billing means that they will provide medical treatment today but wait to get paid at a later date. Third party billing includes any payments made through auto insurance companies, PIP, NO Fault or a Letter of Protection from an attorney. Doctors generally collect these payments when treatment is complete and the personal injury claim in finalized.
Generally speaking, Primary care doctors will not accept third party billing claims, but that’s not always the case. We recommend contacting your PCP to see if they accept auto insurance or do third party billing. Many family doctors don’t like the hassle of dealing with an insurance company and want to collect their money up front. If you reside in a pip state, it may be easier to find doctors who do third party billing.
Third party billing Doctors
Third party billing is when the doctor either waits to get paid through a lawsuit or deals with the insurance company to get paid. Of course, there are no guarantees with third party billing and the Doctor is at the mercy of the attorney to get a settlement. When the doctor deals with the automobile insurance company directly, he or she submits bills to the insurance company for reimbursement.
It is common for a Doctor to deal directly with the insurance company if you have PIP or Med Pay. Otherwise, the Doctor will not deal with the insurance company at all; he will only deal with the attorney. In most cases, Doctors who work with attorneys will receive a medical lien or LOP. A medical lien provides a layer of protection for the Doctor. He will get his bill paid directly out of the proceeds of any settlement that is achieved by the personal injury attorney.
Third party billing doctors may not be medical doctors
Doctors who accept third party billing, in most cases, are not medical Doctors. Doctors who accept auto insurance, PIP or LOPs, are generally Chiropractors. Chiropractic care is one of the most common and effective forms of treatment available for automobile injuries. Chiropractors cannot write prescriptions, so many people attribute this to them not being a real doctor.
If your definition of a doctor is someone who writes prescriptions, then we need to reevaluate your dictionary. Chiropractic care is a safe and effective treatment for automobile injuries. Chiropractic Care uses hands on manipulation of muscle tissue to encourage healing. Furthermore, Chiropractors treat a majority of auto accident injuries in the United States.
In most cases, to qualify for a third party medical claim:
- You were injured
- Were not at-fault for the accident
- You were a passenger in someone else’s car. (If the driver of the vehicle you were riding in was at-fault and you are related, this may cause an issue in some states.)
- Driving a work vehicle that was involved in an accident
Personal injury protection and Med Pay
Pip and Med Pay really does not fall into the category of third party billing. This is due to the fact that you are using your own insurance to see a doctor. This would be considered first party. If you live in a PIP state or have Med Pay, you or the Doctor would deal directly with your own insurance company. Many people still assume that this is third party billing because it is not health insurance, but it falls into the category of doctors who would take auto insurance for payment.
Finding a PIP Doctor or a Med Pay doctor can be challenging as well. You need to find an Third party billing Doctor that accepts this type of insurance for auto injuries. And, if we don’t have a Doctor listed in your area, contact us and we will try and find you one. Every year, we help thousands of auto accident patients find Doctors that will do third party billing. Don’t put off your medical care because you cannot find a doctor.