Resources
Frequently Asked Questions for Providers
After a loss or injury, the legal process can feel complex and overwhelming. This isn’t just your perception—the insurance companies have designed it that way. They know that the less knowledgeable and empowered you are, the easier it is for them to make a profit.
Over our 35 years of advocating for clients, some common questions have come up. We’ve compiled a list of the ones we get most often and our best answers to help make starting or considering the process of hiring an attorney as simple and straightforward as possible.
Insurance Law
What’s a reasonable fee for giving a deposition or my expert opinion?
Multiple factors determine what is “reasonable” to charge for time at a deposition or giving an expert opinion in a spoken or written report. An excellent guideline is what is accepted among the provider’s peers, given their specialty, credentials, additional post-graduate certifications, and the average rate in the location of practice. Fees can include time spent in preparation or in review of the patient’s file, time spent in meetings with the attorney, and time spent on the day of the deposition.
Learn more about how to charge for depositions and giving your expert opinion
How is PIP billed?
Contact the PIP adjuster when treatment begins. Verify the claim number and where you should to submit bills. The PIP insurer should pay you on an ongoing basis.
What’s Uninsured/Underinsured Motorist (UM/UIM) insurance and how does it work?
Uninsured Motorist (UM) and Underinsured Motorist (UIM) insurance is coverage under an injured person’s own auto policy. UM/UIM insurance comes into play when the at-fault driver’s insurance limits aren’t enough to cover the injured person’s claim. In Washington State, insurers must offer UM/UIM coverage equal to the amounts of the liability coverage purchased. UIM/UM coverage can only be rejected in writing.
What do I need to understand about liability insurance?
Liability insurance is required in the state of WA to cover damage done when one driver does harm to another. It is also known as third party, at-fault, or bodily injury insurance. Along with medical bills associated with the crash, it also covers out-of-pocket expenses, lost wages, pain and suffering, and other general damages. You may have a patient whose treatment will ultimately be paid for by another driver’s liability insurance. Your patient will only have a certain amount of time to settle this claim. Settling with a liability insurance company usually happens at the very end of a case, when the full extent of the person’s injuries are known or accounted for and they’ve reached an agreement with the insurance company to settle their entire claim.
What do I need to know about personal injury protection (PIP) insurance?
Personal Injury Protection (PIP) is insurance coverage for medical treatment that is reasonable, necessary and related to a car accident. In Washington State, all auto insurers are required to offer PIP in their policies. It can only be rejected by the applicant in writing. PIP pays medical bills regardless of who’s at fault for a collision. PIP also covers a portion of ongoing wage loss and certain household services that are approved by a provider.
Medical Liens
Do I need to do anything once the lien has been paid?
Once the claim is settled, as a provider, you need to file a “Satisfaction of Lien” no more than 30 days after you’ve received payment. If patient files a lawsuit to compel the provider to file the satisfaction, the provider is on the hook for the costs of the lawsuit, reasonable attorney fees, and any other damages.
Get more information on liens:
How do I file a medical lien?
All medical liens must be filed within 20 days of providing care at your county auditor’s office. The lien is filed by the provider, and is $74.00 per lien with a $1.00 charge for each “conformed”, or complete copy. The conformed copy can be used to make additional copies. It’s best to forward a copy to everyone involved with the claim (patient, insurers, attorneys, etc.). Keep in mind that the lien must be re-filed every year until payment is received from patient’s settlement.
How is a patient’s health insurance used if they are treating for a car collision?
If PIP coverage has exhausted (or if PIP was waived), medical bills should be sent to the patient’s health insurance carrier. According to health insurance companies’ contracts with providers, most plans require that the health insurance company be billed after PIP is used up. When the health insurance’s allowance of visits is also exhausted, your patient may work out an arrangement with their provider/s to hold the remainder of the bills while they finish treatment, and the provider/s may file a medical lien to secure payment at the end of the case.
Medical Records Fees
What do I need to know if a patient requests their records in electronic format?
Per the HITECH Act (Federal Health Information Technology for Economic and Clinical Health), providers can’t charge per page if records are in electronic form – you must deliver the records electronically or in a way that holds electronic information, like a disk. You’re allowed to charge a flat rate of $6.50 for putting the electronic records on disk, sales tax and postage.
See more about handling requests for electronic medical records
How much can a health care provider charge for hard copies of medical records?
As of September 2017, the current WAC (Washington Administration Code) allows for:
- $26.00 Clerical Fee
- $1.17 for first 30 pages
- $.88 per for each page after 30 pages
Postage and WA state sales tax also apply.