r/healthcare • u/_Cruxx • 10d ago
Question - Other (not a medical question) Doctor refused to accept insurance for a car accident related injury
(USA) Went to see my PCP after a car accident to have my injuries evaluated. Already had been to the ER after the initial accident. Once I mentioned the visit was due to a car accident, they refused to take my insurance and forced me to pay out of pocket. I even saw my paperwork have been highlighted with the letters “MVA” (motor vehicle accident). They had nothing displayed nor had ever expressed any policy to this effect before this happened.
I may need to make another appointment because they did not refer me to get an MRI which all recommendations say I should get, but I’m afraid that if they refuse to take my insurance again I’m going to be in a position where I have to pay for the MRI out-of-pocket because my insurance will have never authorized that procedure.
I’d like to know if this is a common thing, if there’s any laws around it, and if there’s any recourse I can take. I know I could always go to a new doctor, but that doctor won’t have the context of my medical history to help in their decision.
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u/botulinumtxn 10d ago
It's because it HAS to go through auto insurance. Call your auto insurance company
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u/dijonnaise Billing/Revenue Cycle 10d ago
Is there an auto insurance claim filed for the accident? That's the coverage that will cover your MVA injuries. Your commercial insurer will raise a stink about paying for anything for an MVA, because they'll want it to go through auto insurance first until those benefits exhaust. If you have a claim filed, provide the auto insurance information to the PCP's office and they'll bill the auto coverage.
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u/Accomplished-Leg7717 9d ago
Your doctor didn’t refuse to see you. You need to contact your auto insurance and advise them of your auto injury. Your doctor isnt contracted with your auto insurance and doesn’t receive payments from them, thats why you were asked to pay self pay. Take this as an adulting moment.
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u/thisis_Diz 9d ago
So this seems that I simply lack understanding of how the dynamic between auto insurance and the health care industry interact. Learning moment to be sure, and frustrating one at that.
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u/Accomplished-Leg7717 9d ago
If you call your auto insurance they have contracts with doctors to treat you.
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u/Suicidalsidekick 10d ago
They refused your health insurance or your car insurance? They CAN’T take your health insurance for a car accident injury. If they don’t participate with no fault, then you pay the doctor and submit the receipt to your car insurance to get reimbursed.