Question About Doctors and Insurance

Updated on May 03, 2012
J.K. asks from Berwyn, IL
7 answers

I'm going to a doctor appt tomorrow, and just thought of a question. 14 years ago, I was in a car accident in which I sustained some whipblash. 2 months later, I started having migraines. I am not sure if the car accident caused it, but suspect it. The case against the driver that hit me was closed a year after the accident (because I was moving cross country).

Here's my question. On the forms for the doctor, is the question "is this related to a car accident". I don't want to check yes since 1) I'm not sure, and 2) I'm worried that my insurance will deny me coverage. Should I avoid telling the doctor about the accident? There's really no other way to explain whipblash which would be important info for the doctor to know.

Edit - a friend of mine thinks that the Obama health care plan nullified the idea of "pre-existing conditions".

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L.M.

answers from New York on

On the form you would answer "no", this visit is not in any way related to the accident. However, when you give your health history you should include this information

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S.B.

answers from Redding on

You check NO.
The medical visit is not related to a claim involving an auto accident.

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B.F.

answers from Minneapolis on

You need to check "not related to an auto accident" if you want your major medical insurance to pay for it. Otherwise, you will have to bill your auto accident insurance for the visit.

note: the auto insurance will deny, because the case is closed. Then you will have to send that denial letter to your health insurance and they may pay. In the meantime, months will have gone by and your doctor will expect you to pay.

this has nothing to do with "pre-existing conditions", it has to do with liability, who is responsible for the bill.

3 moms found this helpful

J.W.

answers from St. Louis on

Okay the Obama health stuff did not nullify anything since it is not in effect at the moment.

Something from 14 years ago that is not being actively treated is not considered a preexisting condition. If you have been actively treated under your previous health insurance and there has been no lapse in coverage it is considered a covered preexisting condition. If it has been actively treated out of pocket it is considered preexisting regardless of whether the accident caused it.

Clear as mud?

If it makes you feel better my husband made me fill out his form for him. :p

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V.T.

answers from Washington DC on

Amanda is absolutely right. They just want to know who to bill, because some doctors bill differently if it was a car accident rather just regular health insurance. Say no because it wasn't caused by an recent accident in which they can recoup their money from a 3rd party.

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~.~.

answers from Tulsa on

Generally, that question is so they file the claim against the auto insurance first before filing on your health insurance. I'd mark no and just address the situation when you see the doc.

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T.A.

answers from Seattle on

It did nullify preexisting conditions to the point where they can't deny you coverage. They still can deny the claim if someone else is responsible, until there is proof that the other person/coverage won't pay. Which you have in this case! I work for a chiropractor and do medical billing, what you should put is that the headaches started after a car accident, which has since been closed/resolved. There's no way after this long that the doctor should put its related to the accident because you've already settled the claim and your health insurance will flag the claim if they do.

1 mom found this helpful
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