Medical Billing Summary: What is included and how to use it effectively

When reviewing voluminous medical bills from numerous healthcare providers, attorneys may overlook some of the bills, or they may not be adept at analyzing the bills. As a result, when calculating the amount of the bills and the special damages that may be sought from the defendant and/or the defendant’s insurance carrier, the amount calculated by the attorney may be inaccurate and too low.

Our staff is trained in medical billing and coding and our Medical Billing Summaries include:

  • The name of the healthcare provider.
  • The date of service.
  • A description of the treatment.
  • The amount of the charge contained in the bill.
  • The amount paid by the insurance company or patient.
  • The amount of any adjustment.
  • The total amounts of the charges, payments and adjustments.
  • A definition of the ICD and CPT codes. (An ICD code identifies a diagnosis and describes a medical condition or disease, and a CPT code describes procedures and services.)

There are various ways to effectively use a Billing Summary. A Billing Summary can be sent to an insurance claims adjuster pre-litigation so that they have a full understanding of the treatment and medical expenses.  It can be provided to a mediator or arbitrator to show the treatment and establish damages. The Billing Summary is also great tool for preparing for a deposition or trial.

Our Medical Billing Summaries have allowed attorneys to seek larger recoveries for their Personal Injury clients. For example, an attorney provided us with a client’s medical bills to review along with the attorney’s calculations. We found that the attorney’s calculations failed to take into account certain treatment and bills, and consequently, the attorney’s calculations were much lower than the amount of the actual bills. Our Medical Billing Summary allowed the attorney to seek a much larger recovery for the client.

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