Medicare - What Does This Mean for You?

What exactly is an Accident Settlement Fund? Is it a separate legal entity from the health care provider? Is it a fund for payouts from medical malpractice cases? The answer to both questions is no. As a matter of fact, it is all three! See here to understand more on what that means.

An Accident Settlement Fund is created when a patient comes to a chiropractic office or other health care provider and suffers an injury as the result of negligence on the part of a health care provider. In many cases, a patient may have been given faulty spinal adjustments by a practitioner and as a result of those adjustments to the patient comes down with a herniated disc. This herniated disc can require surgery to correct and is often accompanied by severe pain that makes it impossible to function properly in day to day life. Rather than paying for expensive hospitalization and surgery, many patients elect to speak with their own doctor about creating an Accident Settlement Fund in their names in order to cover their own living expenses while in the process of recovering from their injury.

The Medicare act provides specific guidelines on how the funds from the fund should be utilized. The act requires providers to divide the funds among the four basic categories outlined in the act: acute and chronic, specialized and inpatient, disability and dependents, and immediate family. Because the fund is considered a taxable income item, it must be used strictly for the purpose specified in the act. For example, if you are entitled to receive a monthly supplement due to your inpatient care at a reputable inpatient rehabilitation center, you cannot use the funds to pay for additional hospital care that you received at home because you received a referral from your chiropractor.

Another guideline under the Medicare act is that if your provider does not participate in the fund, you may be awarded only the benefits the patient would have otherwise received had they been enrolled in the program. For example, if your family physician did not participate in the fund, you would not receive coverage for inpatient rehab services that your family doctor was contracted to provide. Even if the hospital contracted with a direct mail service and sent you a form that you had to sign in order to enroll in the fund, you could not use the funds to pay for the additional services that were not covered by the direct mail service. If your injury is permanent and requires lifetime medical care, the court noted, you may be eligible to receive benefits from the fund based on the actual expenses incurred as a result of your injury.

Medicare is designed to ensure that everyone has access to quality health care. In order to be considered a participant in the program, health care providers must meet the guidelines established by the act. You can visit the USClaims to learn more on Accident Settlement Fund.

Providers who participate in Medicare's Accident Settlement Fund may be required to undergo continuing education, management training, and legal counseling on issues regarding the misuse of the funds. If your provider is not part of the scheme but receives payment from Medicare for the costs of treating a patient in a hospital that is not part of the plan, your bill will likely be referred to a Medicare payment advisor who will determine whether the service meets the guidelines established by the act. Discover more on lawyers here: https://en.wikipedia.org/wiki/Lawyer.

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