Understanding The PIP Suit Process For MA Medical Providers

If you are a medical provider who partners with us to handle your Personal Injury Protection (PIP) claim recoveries, much work and follow-up happens — but you don’t have to do it. Here, we show how the Ged Lawyers system gets it done.

PIP Litigation: A Pain Point for Medical Providers

After road accidents, injured people go to the ER, chiropractors, medical imaging offices, dentists, surgeons, and other providers. What about insurance?

Massachusetts drivers must buy personal Injury Protection (PIP) with $8,000 in coverage. PIP covers various accident-related expenses, including payment for medical treatment — regardless of who caused it.  

Only the first $2,000 (of the $8,000) in benefits can be paid out if the driver has private health insurance. If the person has MassHealth, there is a $6,000 allowance. If the driver does not have private health insurance, a total of $8,000 can be paid out.

The injured patient signs and transfers an Assignment of Benefits (AOB) — providing legal standing for medical providers to demand payment. When insurance companies delay or underpay, many medical providers lack the time, staff, or financial resources to pursue legal action. Some give up. You don't have to.

At Ged Lawyers, we press insurers to meet their obligations under Massachusetts law.

We Make Your PIP Claim Reviews Painless

Processing PIP claims is time-consuming. Patient files contain dozens, even hundreds, of documents. But once you retain our law firm, we work with those documents to return that missing cash flow to your practice.

In our retrospective audit, we index cases and apply an algorithm to identify overdue benefits. Then we submit the claims and handle the entire PIP suit process.

Proactive PIP Risk Management: A Timeline of the Audit and Litigation Process

If necessary, we file suit to collect overdue benefits. Here’s a timeline showing how it works.

• Day 1: You treat and discharge the patient.  
• Day 5: The insurance company receives your bill and has 30 days to pay.
• Day 40 - 45: Your practice receives the Explanation of Benefits (EOB) and the payment.
• Day 45 - 50: Our team at Ged Lawyers audits the payment. Under MA law we can go back up to six years in the past to audit your insurance payouts.
• Day 50 - 55: Ged Lawyers is NOT required to file demand letters with the insurance companies. We go immediately to litigation - typically in the county’s small claims court.

Under Massachusetts' no-fault insurance law, an insurer has 90 days after the claim is submitted to deny or pay the claim — with interest assessed in the interim. Within 90 days from the treatment date, you can expect us to file an action in court if the claim isn’t sufficiently paid. At that point, the insurer risks covering trial costs and attorney’s fees. Most cases will settle pre-trial, resulting in prompt payment to your practice.

In those rare instances in which a trial plays out, we work to minimize your office’s time and involvement in discovery and litigation, knowing that your priority is to focus on your patients.

Partnering With Ged Lawyers Pays Off For Medical Providers. Contact Us To Begin

Claims typically travel to primary health insurance providers, auto insurance companies, and collection agencies. The collections agency may chase cash-strapped patients and will take a percentage from any money it recovers. Our services are worth it to cut inefficiencies and support patients.

We take our fees from the penalties and interest paid by the insurance company, not from you. Your office receives the reimbursement to which you’re entitled. Our clients find this a better way to run a practice and help injured people.

Maximize your PIP benefits today! Contact Ged Lawyers and book an appointment with us, in person, or online.