Motorcycle Injury Medical Bills and Liens in New Orleans, LA Privileges, Balance Billing and Reimbursement

The provider privilege, and what it attaches to

Revised Statute 9:4752 gives a health care provider, hospital or ambulance service a privilege for the reasonable charges or fees of its services on the net amount payable to the injured person out of the total amount of any recovery or sum had, collected or to be collected, whether by judgment, settlement or compromise, from another person on account of the injuries, and on the net amount payable by any insurance company under a contract providing for indemnity or compensation to the injured person. The statute states expressly that the privilege of an attorney has precedence over that privilege. Net amount and precedence are the two words that decide most disputes.

The privilege is not automatic

Revised Statute 9:4753 conditions the privilege on written notice. The claim must be made effective by mailing a written notice, before payment of the insurance proceeds or of the money due from the recovery, by certified mail with return receipt requested, or by facsimile transmission with proof of receipt, to the injured person, to his attorney, to the person alleged to be liable, to the liability insurer, and to any insurer providing indemnity or compensation. Where facsimile proof of receipt is not obtained within seven days, the statute requires the certified mail route. A provider that skipped those steps has a bill, not a perfected privilege.

Contracted providers cannot balance bill

Revised Statute 22:1874 prohibits a contracted health care provider from balance billing, dual billing or attempting to collect from an insured any amount above the contracted reimbursement rate, other than coinsurance, copayments, deductibles and amounts for noncovered services identified by the health insurance issuer. A rider with coverage who is billed the full charge master rate for a trauma admission should read that provision before paying. Determining whether a provider is contracted with the plan, and what the contracted rate was, requires the explanation of benefits alongside the itemized bill rather than the collection notice.

Public program reimbursement follows its own rules

Revised Statute 46:446.6 requires health insurers to accept the Louisiana Department of Health's right of recovery and the recipient's assignment of rights, and to submit payment on a subrogation claim within ninety days where the claim is submitted no later than three years after the date the item or service was furnished, with an enforcement action available within six years. Medicare and ERISA plans assert reimbursement rights under federal law rather than these provisions. The practical consequence is the same either way: a settlement negotiated without resolving reimbursement can leave a rider owing money out of an amount already spent.

Get the itemized bill, not the balance

A statement showing a balance due is not evidence of charges. The itemized bill with procedure codes, the explanation of benefits from any plan, the adjustment and write-off entries, and the payment history together show what was billed, what was allowed, what was paid and what remains. That set is also what allows an inflated charge to be identified before it is presented as damages. Requesting it early is easier than requesting it late, because billing systems archive and providers change vendors.

Liens change the arithmetic of an offer

An offer is not a recovery. Fees, litigation expenses and perfected privileges come out of it, and the order of those deductions changes the number that reaches the rider. The Rules of Professional Conduct require a written fee agreement in a contingent matter, state the shares that apply at settlement, at trial and on appeal, identify which expenses are deducted, and require a written statement at the conclusion showing the outcome and how the remittance was calculated. Asking whether expenses come out before or after the fee is calculated is a question with a dollar answer.

Health coverage, not fault, usually pays first

Medical payments coverage under a motorcycle policy, health insurance, and in some files an uninsured motorist claim under Revised Statute 22:1295, are the sources that pay while a liability claim is pending. Liability carriers do not pay bills as they arrive; Revised Statute 22:1892 ties third-party medical expense payment to a written settlement agreement rather than to receipt of a bill. Understanding that sequence prevents the most damaging mistake in these files, which is stopping treatment because bills are accumulating and no one has offered to pay them.

Information only

This page summarizes published statutes about medical charges, privileges and reimbursement in general terms. It is not billing advice, not a determination that any particular lien is valid or invalid, and not legal advice about a specific claim. Whether a privilege was perfected, or a charge is collectible, depends on documents held by the provider and the insurer. Those documents should go to the attorney who advertises on this site.