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Practice Management Alert

Your Manual for Billing Auto Insurance

Published on Sun Dec 01, 2002

If you're going to travel the auto insurance route, you had better know how to navigate around potholes. Follow these tips for circumventing billing roadblocks when filing auto insurance claims for motor vehicle accidents (MVAs):

  • Keep good records, says Peggy Schaetz, working in the business office at Green Bay Plastic Surgical Associates in Wisconsin. Save all relevant information from patients, insurers and other professionals involved in MVAs. Save your e-mails especially, because you can make copies of conversations and keep them in the patient's chart, she says. Keep track of key phone numbers, contact names, and dates of conversations, and mark your information in the computer with special codes so you can run reports on them, she states.
  • Establish a hospital contact. In addition to establishing good communication with agents, attorneys, the insurer's claims department and the patient, you should look for a hospital contact to find out useful information regarding auto or health insurance, especially from inpatients, whom the contact can visit, Schaetz says. A reliable contact at the doctors' offices can also help, she adds, and share the information you do have with others. That information will help you with your claim details.
  • Fill out your insurance claims completely and send them immediately, Schaetz insists. Get the insurance form filled out as completely as possible. You will have to mail one to the patient and meet the patient at office appointments, she says. Contact auto insurance as quickly as possible, since there's usually a medical maximum on the policy. The first claim in gets the money, she warns, so out-kick competitive submissions with speedy filing.
  • If health insurance is involved, prepare for denials. Don't be surprised if you have trouble billing health insurance after the patient's auto insurance tops out. "If you're lucky enough, health insurance will pay the claim," Schaetz says. When you bill health insurance for the remaining amount, you need to obtain a letter from the auto insurance stating that auto insurance has maxed out, and be prepared for health insurance denials. One medical office reports that it can rarely get an HMO to extend the filing deadline when a patient's auto insurance is exhausted. So, the office bills the health insurance from the start, using the ICD-9 code for MVAs.

    One way around this problem is to notify the HMO before you do any billing. When you encounter an MVA that involves an HMO, make sure you get the referral from the HMO because the MVA will most likely top out quickly, Schaetz says.

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