PIP Collections for Healthcare Professionals
Florida is one of twelve states that require Personal Injury Protection (PIP) coverage as part of all auto insurance policies. The intention of PIP insurance is to provide injured drivers immediate medical coverage, of up to $10,000. As an alternative to establishing fault through the court systems, PIP is supposed to reduce payment delays for the PIP provider. That is not always the case. For Florida’s healthcare providers, PIP payments have historically offered a predictable revenue source. Yet many medical providers find themselves not correctly reimbursed for treating Florida auto accident victims. If this is the case, an attorney versed in Florida PIP collections can drive this effort for you, collecting what you are due for services rendered.
Healthcare professionals may feel forced to accept non-payment or underpayment of benefits, even though Florida law mandates insurer responsibility for costs and attorney fees when PIP benefits have been underpaid or denied. It is therefore critical that Florida healthcare professionals quickly identify and pursue all underpaid claims via a PIP review. This South Florida Hospital News article, published on December 1, 2020, details an important decision that upholds the rights of medical providers.
On May 18th, 2011, Florida’s Fourth District Court of Appeal held that when an individual insurance policy provides for higher payment than the minimum required under Florida’s Personal Injury Protection law, the terms of the policy will dictate payment. This gives medical professionals the ability to collect the balance of PIP benefits for services rendered under insurance policies dating back as far as January 1, 2008.
Given this decision, alongside the realities Florida healthcare professionals face regarding PIP underpayments and denials, it is important that healthcare professionals speak to a knowledgeable Florida lawyer for doctors from Rosenberg Law, P.A. Our firm can evaluate your PIP billing to ensure you are paid outstanding balances for services rendered.
We will review the files in question, then send a written demand letter to the insurance carrier, advising them they have 30 days to pay the claim or we will file suit. If Rosenberg Law, P.A. files suit on your behalf for PIP collections, and we recover money, according to Florida Law, the insurance carrier will also be responsible for our fees, meaning there are no out-of-pocket attorney fees for you. We have offices in Plantation and Sarasota, for your convenience.
How Does PIP in Florida Work for Healthcare Providers?
Following a Florida accident, an insured person may assign their PIP benefits under their insurance policy to a medical provider, who then treats his or her injuries. Florida healthcare professionals work hard to improve the lives and futures of their injured patients and their reimbursement under PIP is well earned. Unfortunately, PIP claims can be complex—demanding time and resources that medical providers feel are more immediately needed in other areas of their practice. Knowing this, insurers may attempt to deny PIP claims for any number of reasons, leading to a reduction in benefits or an outright denial of benefits for the insured patient.
It can be extremely beneficial to have your past unpaid PIP files reviewed by experienced Rosenberg Law, P.A. attorneys. Since Florida PIP law requires all PIP expenses to be paid within 30 days of the date the bill is submitted to the insurance company, invoices that are unpaid or underpaid past this 30-day window are considered legally past due, providing just cause for a Florida healthcare professional to seek legal representation.
And keep in mind that the law is always changing. You may believe that you are not entitled to further payment but a court order may say otherwise.
When medical billings have no justification for denial or reduction (usually found on the Explanation of Benefits) you may have justifiable cause to file a PIP claim in court. You should be mindful of the Florida statute of limitations for recovery of PIP claims—five years from the date of filing. In many cases, a review by a knowledgeable PIP attorney can help recover underpaid or unpaid PIP claims with no out of pocket cost to the healthcare provider.