Attorney Russo Saved His Client Over $34,000 in Outstanding Medical Bills

After securing a maximum settlement of $100,000 for his client who sustained an arthroscopically repaired rotator cuff tear, Attorney Russo was successful in saving his client over $34,000 in outstanding medical bills through enforcement of New Hampshire’s “self-pay statute.”

Attorney Russo explained “when someone walks into an ER or OR, the hospital knows that the patient’s insurance company is only going to pay approximately 40% of the medical bills. The patient is not responsible for the difference. If you look at your explanation of benefits form sent by your health insurance carrier, this is the “adjustment.” Even though the charges are reasonable and customary, the hospital wants to get paid as soon as they can, and the health insurance companies leverage this fact to save money. Let’s say the person doesn’t have health insurance – if the patient doesn’t know any better, sometimes the hospital will try and get paid back dollar-for-dollar. They will try and collect 100% of the bill instead of 40% of the bill. They can’t do that. The law says they can’t profit off someone who is uninsured or self-pay.”

NH RSA 151:12-b, the “self-pay statute” states “[w]hen billing self-pay patients for service rendered, a hospital shall accept as payment in full an amounts no greater than the amount generally build and received by the hospital for that service for patients covered by health insurance. A hospital shall determine the amount generally build the health carriers in a manner consistent with section 9007 of the Patient Protection and Affordable Care Act of 2009.”

In this case, the hospital was trying to say our client owed them over $57,000. They initially refused to negotiate and even retained counsel. Attorney Russo stated “we told them we are going to cut them a check for 40% and give the rest of the money to our client. If they go after our client, we will defend him for free. At the end of the day, they caved. It saved our client $34,000.”