[FOR MEDICAL PROVIDERS] #2 Signing a Medical Authorization to the Adverse Carrier

#2 MISTAKE: Your patient signing a medical authorization for the adverse insurance company

For Providers, How to Help Your Patients Avoid the Most Common Injury Mistakes

QUESTION: What is the risk for my patient in signing a medical authorization before they’re done treating from their car accident.

ANSWER: If your patient signs a medical authorization before they’re done treating from their car accident, the insurance company can use information in your patient’s medical records to justify not paying the medical bills for the medical treatment your patient has and is receiving due to their car accident.

Signing a medical authorization requested by the adverse insurance company is the second biggest mistake your patient can make with regards to their personal injury claim.

Over the years we’ve seen the adverse insurance company use a patient’s medical records to find any reason to put pressure on the PIP carrier to stop paying the medical bills for your patient’s treatment from their car accident. If the PIP carrier receives any information that the treatment your patient is receiving may not be related to the injuries from the accident, they’re going to set up an IME. What we know that means is your patient is going to be cut off by an IME. Ninety-five percent of all IME reports come back saying your patient doesn’t need any further medical treatment. 

Just as you would advise your patient not to settle their claim before they’re done treating from their car accident, the best approach is to sit down with your patient at the start of the treatment to discuss how to deal with the other person’s insurance company. Let them know the importance of not signing a medical authorization until they’re completely done receiving medical treatment from their car accident. 

Giving an explanation as to why they shouldn’t sign the authorization will be helpful for them to understand the importance. Here are the  reasons why they shouldn’t sign the medical authorization: 1) the adverse insurance company is going to use the information to try and get the PIP carrier to stop paying for their medical treatment, and 2) they’re going to tell your patient that they need the information in their medical records to evaluate their claim – which is true. However, they don’t need your patient’s medical records until they’re done treating from the accident.

Adjusters are effective with pressure lines that make your patient feel like they’re being unreasonable for not signing the medical release. By explaining these reasons to your patient, you will be helping them protect themselves and their claim. 

It’s not enough to tell your patient’s what they should and shouldn’t do. To really help them, give them a short explanation as to why they should  follow your guidance. If they understand the “why” behind what you’re telling them, it will help them to understand how to respond to the pressure from the insurance company.



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