It’s the law. To register your car, you need proof of auto insurance, and when you are in an accident, auto insurance helps you pay medical bills. But beware of the fine print.
NPR recently ran a Bill of the Month segment focusing on excessive medical bills. The September 2022 segment featured a Georgia family, the Cooks, whose teenage daughter lost control of her vehicle after heavy rains. Frankie was wearing her seat belt, and the airbag was deployed after she rolled her car. She walked away with a bad headache and no other injuries but wanted to be checked out by a doctor. Her father, Russell, took her to a nearby urgent care center in their network but did not make it past the front desk.
The Atrium Health Floyd Urgent Care receptionist in Rome, GA, told Russell that they don’t take third-party insurance and he would have to take his daughter to the emergency room. The family had good health insurance, but because it was an auto accident, the clinic would not accept the Cook’s auto insurance as the primary insurance responsible for Frankie’s medical bills.
At the emergency room, a doctor examined Frankie for a few minutes and then sent her for precautionary CT scans of her head and body. She did not have a concussion or a severe head injury, so the doctor sent her home with the advice to take some Tylenol and rest.
The emergency room bill initially cost $17,005, which was later adjusted to $11,805 after removing a duplicate charge.
Urgent Care Association CEO Lou Ellen Horwitz said on NPR that this is pretty standard for urgent care centers not to treat injuries resulting from car accidents, even minor ones. “Generally, as a rule, they do not take care of car accident victims regardless of the extent of their injuries because it is going to go through that auto insurance claims process before the provider gets paid.”
The urgent care center that Frankie originally went to did not have a CT scanning machine. She would have likely been referred to the hospital anyway. If Frankie had been admitted to the urgent care center, the Cooks would need to pay for both the UC plus the emergency room visit. Horwitz added that ‘unfortunately’ people tend to learn about such policies when they show up expecting care.
Horwitz dismissed the idea that a health system, which owns both the urgent care center and the nearby hospital (such as in the Cook’s case), might steer people involved in car accidents to emergency rooms to make more money.
Horwitz added that auto insurance eventually pays more than health insurance for the same services.
It took 16 months before Russell paid his portion of Frankie’s bill, which was $1,042. It was a lengthy process to have the duplicate charge removed. The family’s health insurance paid $4,006 of the cost of the emergency room visit, while their car insurance paid the rest of the bill. Russell said that his portion did not break the bank, but he still would have loved a $200 urgent care visit bill instead.
NPR said in their takeaway:
“It’s important to remember that urgent care centers aren’t governed by the same laws as emergency rooms and that they can be more selective about who they treat. Sometimes their reasons are financial, not clinical.”
Jalopnik also reported on the NPR story and stated that using this family’s example, research your insurance situation and have an accident care plan ready should you be involved in a traffic accident.
So, what can we learn from this experience?
- When you have two “competing” forms of medical coverage, there’s COB (coordination of benefits), which means that the provider doesn’t get paid twice. One is primary, and the other is secondary.
- When an accident involves two people, someone is usually deemed to be at fault, unless it’s a no-fault state, in which case expenses are shared 50-50 regardless. So unless it’s a no-fault state, the insurance companies duke it out to clarify who is on the hook to pay.
- In the situation described above, no other party was involved. There was no issue of who was at fault.
- Whenever an airbag is deployed, then it is officially considered an accident. When airbags deploy (especially with shorter people), there is a risk of head trauma or a concussion, and it’s not the type of thing that should be self-diagnosed.
- Urgent care centers lack the diagnostics and imaging that hospitals do, so while going to a UC may seem fiscally responsible (“I only had a mild headache”), it’s not the right thing to do.
- After an accident, doing nothing short of going to the ER, all the other stuff doesn’t matter because it will get hashed out between your car insurer and your health insurers.
