Medical Provider No-Fault Collections
Unpaid No-Fault Claims Are Not the Cost of Doing Business
If your practice treats auto accident patients in Michigan, you know the pattern: care is delivered, claims are submitted, and the carrier delays, underpays under a disputed fee-schedule calculation, or denies outright. Many providers write these balances off as the price of treating no-fault patients. They are not. Michigan law gives medical providers a direct cause of action against no-fault insurers, and provider reimbursement is a core part of Koussan Law's practice. We have recovered over $50,000,000 for a single provider client against carriers that refused to pay for auto-related treatment.
Who We Represent
Koussan Law represents neurosurgeons, orthopedic surgeons, pain management providers, ambulatory surgery centers, and ancillary providers such as medical transportation and attendant care companies. Whether the dispute is a single high-value surgical claim or a portfolio of aged receivables across hundreds of dates of service, we litigate provider reimbursement as a first-class practice, with the same trial team that handles our catastrophic injury cases.
The Legal Basis for Provider Claims
Since Michigan's 2019 no-fault reform, MCL 500.3112 expressly permits a healthcare provider to make a direct claim and bring a direct action against the no-fault insurer for payment of benefits owed for the care it provided. Reimbursement amounts are governed by the fee schedule in MCL 500.3157, and carriers frequently apply it incorrectly. Timing is unforgiving: under MCL 500.3145, the one-year-back rule generally bars recovery for treatment rendered more than one year before suit is filed. Every month a denied claim sits in accounts receivable, recoverable value expires.
Results for Provider Clients
Koussan Law has recovered over $50,000,000 for a single client against auto insurance carriers refusing to pay medical providers for auto-related treatments, along with multi-million-dollar recoveries on behalf of neurosurgeons, orthopedic surgeons, and pain management providers, and multi-million-dollar recoveries on behalf of ambulatory surgery center clients against insurance carriers. See our results. Past results afford no guarantee of future results; every claim is judged on its own merits.
Frequently Asked Questions
Q: Can a medical provider sue a no-fault insurer directly in Michigan?
Yes. Since the 2019 reform, MCL 500.3112 gives providers a statutory direct cause of action against the insurer for benefits payable for the treatment they rendered. A provider no longer depends on the injured person's cooperation to pursue payment, though coordination with the patient's claim often strengthens both.
Q: How long does a provider have to act on an unpaid claim?
The one-year-back rule in MCL 500.3145 generally limits recovery to expenses incurred within one year before the lawsuit is filed. In practice, aged receivables lose recoverable value every month. A portfolio review should happen as soon as a pattern of denials or underpayments appears, not at year-end.
Q: The carrier paid, but at a reduced fee-schedule amount. Is that worth disputing?
Often, yes. Carriers routinely miscalculate the MCL 500.3157 fee schedule: wrong base year, wrong Medicare benchmark, wrong facility classification, or services misclassified as outside the schedule entirely. Systematic underpayment across a claim portfolio can add up to significant recoverable sums.
Q: What does it cost to engage Koussan Law on provider collections?
The initial portfolio review is free. Call (313) 800-0000 and we will review your unpaid and underpaid no-fault receivables, tell you what is recoverable, and propose an engagement structure that fits your practice.
