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How Can A Physician's Office Assist Claimants Attorneys On Personal Injury Cases?
Description
A Las Vegas personal injury lawyer discusses how physicians' offices can assist their personal injury patients' Attorneys settle accident injury claims.Article
In my 25 years of experience as a personal injury attorney, I have dealt with many of the healthcare facilities in the Las Vegas area, who treat patients that have been involved in accident cases.Some physicians that deal with personal injury cases on a regular basis are aware of the following office procedures that can be extremely helpful on personal injury claims and lawsuits:
1. A Clean Bill.
It is extremely helpful for a personal injury attorney to have a clean bill. What this means is that the bill contains only the dates and amounts of all charges by the healthcare provider. A clean bill does not contain any information on health insurance payments and also contains a figure which represents total charges for services rendered by the provider for the accident.
In the event that the attorney receives a bill with insurance payment information, this devalues a claim because the adverse carrier knows that first party insurance has paid all or some of the patient's bill. If an adverse adjuster knows that bills are paid by first party insurance, such as auto med pay with no right of subrogation, he will offer a lesser amount to settle the claim.
Also, an attorney cannot file any documents with the Court that contain a patient's social security number. This data must be redacted. Don't include the patient's social security number on your bill. Bills that are submitted to the Court as evidence in a personal injury case must also be redacted for insurance information.
Health insurance claim form(s) are particularly problematic for personal injury attorneys because the insurance information is replete throughout the form and redaction of insurance information is a very time consuming process.
For these reasons, personal injury attorneys love clean bills.
2. Organization of a personal injury medical file.
For reasons stated in No. 1 above, all information regarding insurance should be placed in one section of a medical file. Once again, the reason for this is because all insurance information must be redacted from medical records which are the subject of a trial. If all of the insurance information is kept in a separate section of a file and segregated from the medical records, this is very helpful to the personal injury attorney as far as redactation of records is concerned.
Intake forms often include insurance information mixed in with patient history and symptomology. Redactation is a simple process when all insurance information is segregated. We can just eliminate those pages from our trial exhibits.
3. Medical necessity.
In order for medical bills to be admitted into evidence, there must be a statement by the healthcare provider concerning the medical necessity of the treatment. In other words, the treatment must be medically necessary for the treatment of injuries resulting from a particular accident.
Generally speaking, this statement of medical necessity is very helpful to an attorney during an arbitration or a short trial. In these proceedings, it is not necessary for the doctor to actually appear to give testimony in the event that his medical records contain a statement of medical necessity and other evidentiary requirements. The doctor in his discharge report or in his medical records can simply state that, "In my opinion, all treatment rendered to the patient (from first date of treatment to last date of treatment) was medically necessary to treat injuries that the patient received in her accident of (date of accident)."
4. Medical causation.
In order for a Plaintiff to prevail in a personal injury case, medical evidence must contain a statement by a physician concerning causation. That statement can be, "It is my opinion to a reasonable degree of medical probability the injuries that I diagnosed and treated the patient for were caused by the accident of (date of accident)." The healthcare provider can simply include such a statement in his records or narrative reports.
5. Reasonable and Customary Charges.
This statement is extremely helpful on mediation, arbitration and short trial cases. In order to admit a medical bill into evidence, the attorney must lay a foundation that the charges for the medical treatment were reasonable in amount and are customary charges for same or similar services in the Las Vegas area.
The physician in his narrative or medical records can once again simply state that, "I have reviewed the billings for this patient. In my opinion, the charges for services rendered by my facility were reasonable in amount and customary charges for the Las Vegas medical community."
Once again, this information will eliminate the need to have the medical provider actually testify in an arbitration or short trial proceeding. This is especially important if there are numerous medical providers. Attorneys can't afford to bring all providers to a short trial. Even if you win, you can only receive $500.00 per expert.
In the event that the healthcare provider does not provide information concerning medical necessity, causation and reasonable and customary charges, the attorney can provide the healthcare provide with an affidavit that he can sign which can be used in mediation, arbitration and the short trial program, so that the medical bills and records of the provider meet legal foundational requirements for admissibility.
6. Depositions.
The healthcare provider should be prepared during deposition to testify concerning medical necessity, causation and reasonable and customary charges. Oftentimes, healthcare providers during deposition have absolutely no idea of what their facility charged the patient. They are ill-prepared to testify on matters of reasonable and customary charges. Many physicians have never seen their client's bill.
In preparation for a deposition, the healthcare provider should review his bill and the charges and be prepared to testify concerning reasonable and customary charges. The healthcare provider should also understand and be prepared to testify concerning opinions on medical necessity and causation. Most healthcare providers give adequate testimony concerning their records, but are very weak when it comes to their testimony in these three areas.
All of the areas covered in this article should be common knowledge to healthcare providers that are involved with personal injury cases. We have seen a tremendous turnover in medical facilities that deal with personal injury cases in recent years. Many of the new healthcare providers that are treating patient's on personal injury cases, do not have much experience at litigation. The information contained in this article is critical to the healthcare provider in understanding his role in assisting his patients on injury claims and during litigation.
About the Author
Allen A. Cap, Esq. is an attorney at the Las Vegas, Nevada law firm of Cap & Kudler. Additional information can be found at http://www.capandkudler.com and http://www.vegaspersonalinjurylawblog.com/blog. He can be reached at (702) 878-8778 or by email at allencap@capandkudler.com.About the Article
Category 1: Legal
Keywords: personal injury, accident injury, lawyer, Las Vegas