Many of our truck/auto crash victim clients are on Medicare. When Medicare pays(see website below for a step by step outline of the process) medical bills related to liability claims you can expect to receive a letter from Medicare requiring you to provide information about your injury some details about the parties involved in the case. If you have an attorney experienced in personal injury cases, this letter should be forwarded to him/her for processing. All of the parties concerned with a claim for injuries in which Medicare has paid have some reporting responsibility under the federal regulations. This includes the insurance company, your attorney and the defense attorney, if any. For instances, when a injured party is known to the insurance company to be a Medicare benificiary, it must send notice to Medicare that a claim is pending and that payments may be made to the injured party. Heavy fines can be imposed for failure of the insurance company to comply. Likewise, once a claim has been settled, notice of the settlement must be transmitted to Medicare so that the reimbursement process can be brought to a conclusion. Thus, the insurance companies will almost always investigate the claimant's status insofar is Medicare is concerned. And this means that almost always the injured party will have to deal with Medicare. This process can be tedious and aggravating if it is not handled correctly. In our office we have a paralegal trained to handle Medicare claims and it has really helped us streamline the process for our clients. It is common for the paralegal to be placed on "hold" for more than an hour.
Fortunately for the claimants, once you successfully go through the process, Medicare usually pays much less than the amount shown on the bill. Also, Medicare deducts from the 'pay back' the amount of the procurement costs including attorneys fees. In other words the amount of the required reimbursement is reduced by the attorney fees. Thus the efforts of the attorney are recognized and the injured party is not penalized by having an attorney involved with this aspect of the case.
Insurance companies will abide by the federal regulations on Medicare reimbursement because if the don't they are subject to fines and may even be required to pay Medicare in addition to paying the claimant. Worker's compensation cases may require a set aside trust to deal with future medical bills related to the accident or on the job injury. Set aside trust may also be required in some types of tort claims. For more information go to the web site;
A new online Self-Service Tool to help manage your Medicare recovery case:
http://www.msprc.info/