When a surgeon bills one of my injured clients $75,000 or more for a single surgical procedure, several things happen, not necessarily in this sequence:
1. I regret my decision to attend law school rather than medical school.
2. I wonder if there has been a typo on the bill.
3. Any group health insurance company to whom the bill is submitted immediately pulls out its microscope and chopping knife.
4. Any insurance adjuster to whom I provide the bill as part of a claim raises serious questions about the credentials of the surgeon, the nature of the surgery, the reasonableness of the charges and, ultimately, the validity of the liability claim I am submitting.
Think how you would react if you were told your cup of coffee was a $25 item. (Starbucks excluded.)
Unreasonably high (read that outrageously high) medical charges are not helpful to anyone making a personal injury claim. They often require me to have chats with medical providers and to work much harder in the negotiations with the liability insurance company. Sometimes an astronomically high surgeon’s bill forces a claim into litigation.
Once in litigation the reasonableness of the surgeon’s bill, as well as all medical charges, is a matter of proof. The Illinois Trial Practice Weblog has a series of articles on medical bills which provide an overview of the issues and procedures involved. Although the articles are written for attorneys they demonstrate the effort required by the civil trial lawyer just to achieve jury consideration of medical expenses.
In most jurisdictions, including Illinois, proving up medical bills at trial requires evidence that the charges for medical services were reasonable. Usually, the reasonableness of a bill can be easily established with proof that the bill was paid. But what if the bill hasn’t been paid yet?
If the bill hasn’t been paid, you’ll have to work a little harder.