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Is my medical treatment provider overcharging me?

massageYour medical treatment providers should always put your best interests first. Unfortunately, medicine is a lucrative injury, and some providers have found that there are some easy ways to make more money that aren’t proving more benefit to their patients.

As you recover after an accident, watch out for these red flags from massage therapists, chiropractors, physical therapists, and anyone else who is providing treatment for your injuries after your accident. When in doubt, ask your primary care physician if they think a suggested course of treatment is reasonable and necessary to your recovery.

Pushing you towards treatment that hasn’t been prescribed by your doctor

After an accident, you should be following up regularly with your primary care physician, and with any other specialists they referred you to (such as an orthopedist or neurologist). These doctors may write you a prescription for other medical services, such as physical therapy, chiropractic therapy, massage therapy, or other types of care.

Some unscrupulous treatment providers will try to over-treat you after an accident. Yes, too much medical care can be a bad thing—especially when it comes to personal injury cases, because insurance companies will argue that they don’t have to pay for treatments that went far beyond usual post-accident care in frequency and cost.

Telling you to stay in intensive treatment for months after you stop seeing improvement

There may be times when your experience with a particular treatment will “plateau,” meaning that you stop seeing gains in strength, functionality, and pain reduction from that particular treatment. This often means that you have received all the improvement that you are going to see from this particular therapeutic method, or that you need to drop back to something you can do less frequently or at home.

A provider who responds to a plateau by telling you that you need more of this particular type of treatment may be thinking of their bottom line rather than your best interests. The goal of treatment after an accident is to get patients as close as possible to the lifestyle they had before, not to force them into treatment that doesn’t have any effect on their well-being.

Refusing to show you a bill

While medical billing can get complicated, your treatment provider should respond quickly to requests from you or your attorney for billing statements or an itemized list of treatments performed. Anyone who is cagey about giving out this information may be trying to conceal how high your bill has become or how far beyond the acceptable standard of care they have gone.

Telling you that you should waive your right to have them bill your auto or health insurance carrier

Health insurance and PIP (personal injury protection, a pot of money provided for your own insurance carrier for your medical treatment) sometimes have limits on how much money you can spend or how many sessions of a particular type of therapy they will cover.

If you have health or auto insurance that will cover your treatment, tell your medical provider to bill that, and watch out for providers who try to talk you out of that. The most unscrupulous providers may be trying to get you to agree to more treatments than the “cap” your insurance providers allow.

Suddenly deciding you need more treatment when they find out that you have been in an accident and have an attorney

Over the course of your recovery, it’s possible that your treatment plan may change as your doctor and therapists see whether you are recovering more quickly or slowly than expected. What shouldn’t happen is a sudden push towards a more intense course of treatment right after your therapist finds out that you have a legal case or you’ve just hired an attorney. Speak to your doctor if you have any concerns about the frequency of your therapy sessions suddenly changing.

Telling you that you have invisible, chronic ailments

After an accident, it may take some time to sort out your diagnoses. Some injuries, like soft tissue damage, are difficult to see on the scans that doctors use to diagnose you; it’s possible, indeed probable, that you will be feeling some pain in areas that wouldn’t read as abnormal on an x-ray or MRI.

Some very unscrupulous therapists may try to convince their patients that they have developed a chronic soft tissue condition, like whiplash, that will keep them in intensive treatment for a very long time. While whiplash is indeed a real condition, some medical treatment providers will try to overstate the severity of a particular case or provide more treatment than is actually necessary. You should always ask your primary care doctor or a specialist for a second opinion and a recommendation for treatment if a therapy provider has told you that you have a condition that will require years or decades of expensive care.

Pushing you towards unusual and untested treatments

If a treatment provider tells you about a type of therapy you haven’t heard of before, or one that you know isn’t generally considered part of “western” medicine, talk to your doctor before agreeing to that treatment. It would also be a wise idea to let your lawyer or paralegal know whenever you’re about to start a new form of treatment.

Your own insurance or your settlement may cover some treatments, like acupuncture, that have a proven record of helping with pain relief. However, there will probably be limits on how many sessions are covered. There are also some types of treatment, like reiki healing, that will probably not be recommended by a doctor or covered by insurance even if you report that they are helping you with your pain.

Before beginning a treatment, make sure you understand whether or not the money for that treatment will be coming out of your own pocket.

Chris Davis
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Chris Davis is the founder of Davis Law Group, P.S. in Seattle, WA.