Michigan No-Fault Medical Provider Lawyer

like a chiropractor, imaging center, or other professional who handles automobile injury cases, it may be time to hire your own team of dedicated personal injury attorneys to help you get paid.

A Michigan no-fault medical provider lawyer from Wigod & Falzon can work diligently to strategically pursue the compensation you are entitled to for the services you provide.

What Are Michigan’s No-Fault Benefits?

As you know, those who have been injured in an automobile accident are legally entitled to collect No-Fault benefits under the personal protection insurance coverage of their auto insurance policy.

These benefits provide valuable protections to assist in recovery, helping with common costs like:

• Medical care expenses
• Medical mileage
• Wage loss
• Replacement services
• Attendant care
• Home modifications
• Vehicle modifications

What Are Medical Provider Rights Under This Law?

In 2017, the Michigan Supreme Court handed down a decision called Covenant Medical Center versus State Farm. This held that medical providers didn’t have the right to pursue legal action against a no-fault insurer.

However, the major no-fault overhaul in 2019 changed everything; now, under the no-fault law, medical providers have the right yet again to pursue legal action against the no-fault insurance provider directly.

Now medical providers like chiropractors, home health professionals, and others handling auto no-fault claims in Michigan can receive unpaid no-fault medical services in the name of their organization, instead of through an assignment of benefits from a patient.

Bottom line: Medical providers no longer have to rely solely on assignments from injured patients to pursue payment. Michigan law now allows eligible providers to bring certain claims directly against the patient’s no-fault insurer for unpaid medical services. This is where a Michigan no-fault medical provider attorney can be extremely helpful.

Reasonable and Customary Fee Disputes

Not every dispute with a Michigan no-fault insurer involves a complete denial of payment. In many cases, the insurer argues that the provider’s charges exceed what it considers a reasonable and customary fee. These partial payments can leave you with the rest of the bill.

These reasonable and customary fee disputes are among the most common issues arising in Michigan no-fault claims. They often involve disagreements over reimbursement rates, billing methodologies, fee schedules, or the value of specialized medical services. Successfully resolving these disputes may require reviewing billing records, medical documentation, industry reimbursement standards, and the insurer’s basis for reducing payment.

Our firm is experienced with chiropractor unpaid no-fault claims in Michigan, home health agency no-fault legal cases, imaging center no-fault payment disputes, and much more.

Assignment of Benefits in Michigan No-Fault Cases

An Assignment of Benefits is a legal document allowing an injured patient to transfer certain rights under their Michigan no-fault insurance policy to a medical provider. Before Michigan’s 2019 no-fault amendments, providers often relied on this to pursue payment directly from an insurer if bills for the facility went unpaid.

While the Assignment of Benefits may still be relevant in some situations, providers are no longer solely dependent on a patient during the collection process.

Our legal team can evaluate whether an Assignment of Benefits is the most effective option in your no-fault medical provider case.

The One-Year Back Rule for Michigan No-Fault Claims

Michigan’s one-year-back rule can significantly affect a medical provider’s ability to recover unpaid benefits. Michigan Law Section 500.3145 is the no-fault medical provider law that covers the one-year timeframe for taking legal action. Waiting too long to pursue legal action can result in a person permanently losing the right to recover damages, even for covered expenses.

Common reasons people wait include:

• Uncertainty over whether to contact the patient or the insurance company
• Backlogs at their medical facility that make it hard to pursue a claim alone
• The hope that insurance providers will cover the costs voluntarily

Medical providers must monitor outstanding balances and act promptly when an insurance provider delays, denies, or underpays a valid claim. Early legal intervention may help preserve your ability to recover the full amount available under Michigan law.

When you contact a skilled Michigan no-fault medical provider attorney from our firm, we can help you streamline the legal process, allowing you to operate within the allotted timeframe. This frees you up to focus on your medical practice, while allowing us to put more than 25 years of legal experience to work for you in your no-fault medical provider case.

Next Steps: Hire a No-Fault Medical Provider Lawyer Now

Under Michigan law, you have the right to retain your own attorney to represent you for your medical bill collection. An experienced medical provider defense lawyer from our firm has the experience you can rely on.

Michigan has a thriving healthcare industry, with hospitals alone employing 222,000 individuals. We are proud to serve medical facilities throughout Metro Detroit, Southfield, and Jackson County.

When you hire a no-fault medical provider lawyer from our firm, we can help you pursue unpaid benefits, challenge improper denials or reductions, and work to recover the compensation your practice is entitled to receive under Michigan law.

Reach out to us for a free, no-commitment consultation today.

Michigan Related No-Fault Medical Provider Resources:

• Michigan Assigned Claims Plan: What You Need to Know
• Michigan Court of Appeals Clarifies No-Fault Priority: Mary Free Bed Rehabilitation Hospital v. Esurance
• Michigan Slip and Fall Law Changes
• Medicaid and Personal Injury Settlements: Is There a Connection?

Michigan No-Fault Medical Provider Legal Resources

• • Michigan Compiled Laws § 500.3145 – One-Year-Back Rule for No-Fault Actions
  • Michigan Compiled Laws § 500.3157 – No-Fault Provider Reimbursement / Fee Schedule Statute
  • Michigan Department of Insurance and Financial Services – No-Fault Frequently Asked Questions for Providers
  • Michigan Department of Insurance and Financial Services – Auto Insurance Fee Schedule Resources and Bulletins