Accident and third-party liability information

How do we capture accident, attorney and auto or workers' compensation insurer details when an injury may be another party's liability, and route them to billing?

Ask the liability questions once, at the right moment, and route the answers to the right payer path. When a visit involves an injury, Callvu prefills the patient and the encounter, classifies the injury's circumstances from the first answers (a motor vehicle accident, a work injury, a fall on someone's premises, an assault, a product), asks the patient on their phone only the questions the circumstances need (the date and place, the auto or no-fault insurer and claim number, the employer and the workers' compensation carrier, the attorney's details, the other party's insurer), chases the missing items and the authorizations through links, verifies the carriers where possible, and writes the liability record to the billing system and the EHR's registration so the claim goes to the right payer first and the health plan is billed only as the rules allow.

In scopeComplex: multi-party handoffsCallvu moves: prefill, classify, chase and verify, write back

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Last updated November 7, 2026.

The problem today

The emergency visit after the car accident was billed to the health plan, which paid, then recouped eight months later when it learned there was an auto insurer.

Today, without Callvu

An injury visit may be someone else's bill: an auto or no-fault insurer, a workers' compensation carrier, a premises or product liability carrier. Registration asks 'is this an accident?' and moves on; the claim goes to the health plan; the health plan pays and later recoups, or Medicare's secondary payer rules put the hospital on the hook. The attorney's lien letter arrives after the account has been written off.

The questions are known and depend on the circumstances: for a motor vehicle accident the auto insurer, the policy, the claim number and whether the state is no-fault; for a work injury the employer, the carrier and the claim; for a premises injury the owner and their insurer; in every case any attorney and the other party. Medicare's secondary payer rules require the questions at admission; the state's lien laws give the hospital rights against the recovery; the health plan's contract may require the liability payer be billed first.

The questions asked at the visit, in the patient's words, are the difference between a paid claim and a recoupment.

How it runs

From the requestto the system of record.

A visit involves an injury (flagged at registration, triage or by the diagnosis codes), or a payer or an attorney contacts the hospital about one. Callvu opens the liability case on the encounter.

Patient or guarantor: Answers the questions for the circumstances, uploads documents and signs any authorization on their phone.
Billing and the liability or workers' compensation desk: Receive the record and decide the payer path in the Decision Desk.
Carriers and attorneys: Confirm claims and representation through their channels.
Callvu: Prefills, classifies, asks, chases, verifies and writes.

Prefill and classify
The patient, the encounter, the diagnosis codes and the coverage on file are prefilled; the first answers (how the injury happened, where, whether a vehicle or work was involved) classify the circumstances: a motor vehicle accident (and the state's no-fault status), a work injury, a premises or product injury, an assault, or no third party, which sets the questions and the payer path.
Ask and chase and verify
The patient answers only the questions the circumstances need on their phone: the date, the place and the description, the auto insurer, the policy and the claim number, the employer and the workers' compensation carrier and the claim, the premises owner and their insurer, the attorney's details, the other party and their insurer; documents (a claim letter, an attorney's letter, the police report number) are uploaded; the missing items are chased through links to the patient and, with the patient's authorization, to the attorney or the carrier; the carriers and the claims are verified where the payer allows.
Decide the payer path
The billing or liability desk decides in the Decision Desk with the record and only the allowed outcomes: bill the liability or no-fault carrier first, bill workers' compensation, bill the health plan with the liability information attached as its contract allows, hold for the attorney's lien process, or treat as no third party; the Medicare Secondary Payer determination is recorded where Medicare is involved.
Write back
The liability record (the circumstances, the carriers, the claim numbers, the attorney, the authorizations and the payer path) is written to the billing system and the EHR's registration record, the claim is routed to the first payer with the accident indicators the claim standard requires, the lien is filed under the state's law where the policy provides, and the case is tracked until the liability payer pays, denies or the recovery is settled.

Where it ends: The liability questions were asked once at the visit, classified to the circumstances, chased and verified, and the billing system holds the record that sends the claim to the right payer first and keeps the health plan from a later recoupment. The Decision Trace shows the classification and the payer path decision; the Audit Trace shows the answers, the chases and the writes with time.

Runtime enforcement

What is enforcedwhile the work runs.

The regulations preloaded in Callvu Studio and the bank's own policies, applied as steps that run, not lines in a binder. A step that breaks a rule does not run, so a completed run was compliant.

Regulations

Medicare Secondary Payer rules (42 USC 1395y(b), 42 CFR 411.20 to 411.54) and the MSP questionnaire: Medicare is secondary to liability insurance (including self-insurance), no-fault insurance and workers' compensation; providers must ask the MSP questions at admission and bill the primary payer first, may bill Medicare conditionally where the primary does not pay promptly (120 days), and must refund Medicare if a liability settlement later pays; the liability record evidences the questions asked and the determination.
State hospital lien laws and workers' compensation billing rules: Most states give a hospital a lien on a patient's recovery from a third party for the reasonable charges of the care, perfected by filing and notice within the statute's period; workers' compensation carriers pay under the state fee schedule and require the claim to be accepted and billed to the carrier, not the health plan.
No-fault and personal injury protection statutes, the health plan's coordination and subrogation terms, and the claim standard's accident indicators: In no-fault states the auto insurer pays medical benefits first up to the limit; the health plan's contract and its subrogation terms set when it may be billed and what information it requires; the claim carries the accident date and the related-cause indicators the standard transaction defines.

Company policies

The liability questions are asked at the injury visit, in the patient's words, by circumstance; never a single checkbox.
The payer path is decided by the desk with the record; the liability or no-fault payer is billed first where the rules require.
The health plan is billed only as its contract and the Medicare rules allow, with the liability information attached.
The billing system and the registration record hold the liability record; the billing system is the system of record for the claim path.

Controls

Injury flag and circumstance classification.
Circumstance-specific questions on the patient's phone.
Chases to the patient, the attorney and the carriers with authorization.
Carrier and claim verification.
Decision Desk payer path decision with the MSP determination.
Billing system and registration write, claim routing, lien filing and tracking.

Clocks and deadlines

Conditional Medicare billing: After 120 days without the primary's payment, where Medicare applies.
Lien filing: The state statute's period from the service for perfection and notice.
Liability payer follow-up: Tracked until payment, denial or settlement.

Documents and checks

The circumstances and the classification
The carriers, claims, attorney and other party details
The authorizations and the uploaded documents
The payer path decision
The billing system and registration record, the claim and the lien

In the Decision Trace

The classification and the questions asked.
The payer path decision and the person.
The MSP determination.

In the Audit Trace

The answers with time.
Each chase and verification with time.
The writes, the claim and the lien.

The handoff

Between the front doorand the back office.

The front door

Registration, triage or a text after the visit; the patient answers on their phone; attorneys and carriers through their channels.

The back office

Billing receives a complete liability record and decides the path; the claim and the lien follow from it.

The Decision Desk

Every third-party case goes to the billing or liability desk in the Decision Desk with the record and only bill the liability or no-fault carrier first, bill workers' compensation, bill the health plan with the information attached, hold for the lien process, or treat as no third party.

Proof

In scope.Proof at scale, not one process at a time.

The kind of process Callvu runs in production for customers in this industry. Ask for a reference on this exact process. The results below are the industry's published proof; each claim code links to its record on agents.callvu.com.

23 hospitals in the Ministry of Health network run on Callvu.

Across Callvu customers

More than 1,000 processes are live across Callvu customers.

Across Callvu customers

Questions

What buyers ask next,answered plainly.

What is asked?

Only the questions the circumstances need: the auto insurer and claim for a vehicle accident, the employer and carrier for a work injury, the premises owner's insurer for a fall, and in every case the attorney and the other party, on the patient's phone.

Who is billed first?

The liability, no-fault or workers' compensation payer where the rules require, with the health plan billed only as its contract and the Medicare Secondary Payer rules allow; the desk decides the path with the record.

What about the hospital's lien?

Where the policy provides, the lien is filed and noticed under the state's statute within its period, and the case is tracked to the recovery.

Related processes

Coordination of benefits updates Insurance eligibility verification Insurance update and rebill New patient intake with insurance check Try it in the sandbox All healthcare processes

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