Understanding The PIP Suit Process For Medical Providers
by Marius Ged, on Sep 17, 2020 7:43:00 PM
If you are a medical provider who partners with us to handle your Personal Injury Protection (PIP) claim recoveries, a great deal of work and follow-up happens — but you don’t have to do it. Here, we show how 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?
Florida drivers must buy Personal Injury Protection (PIP) with $10,000 in coverage. PIP covers various accident-related expenses, including payment for medical treatment — regardless of who caused it.
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 Florida 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 the attorneys at Ged Lawyers, 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 attorneys and customer service representatives audit your insurance payout history.
- Day 50 - 55: Before litigation, Florida law requires a demand letter to be sent to the insurance company, allowing it 30 days to respond with payment after receiving the message. This delivery gives the insurer notice of forthcoming legal action if the fees for your services are not paid.
- Day 80 - 85: If, after 30 days, proper payment is not forthcoming, our attorneys determine if the company’s nonpayment or underpayment is proper under Florida’s no-fault insurance provisions. If not, we immediately begin litigation, typically in the county’s small claims court.
Under Florida's 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 of any money it recovers.
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.