The Complexities of PIP Billing in “No Fault” Auto Insurance States

Posted by admin | August 31, 2017 , (0) comments







If you are a health care provider at a small practice, you might be surprised to find out that the auto insurance laws in your state have the potential to significantly impact your revenue cycle. This is particularly true in states that have “no fault” auto insurance laws. Under this type of system, the auto insurance company pays for damages from motor vehicle accidents — including medical bills — up to a certain limit, regardless of whether or not the driver was at fault. This means that the health care provider who treats the driver must contend with the complexities of personal insurance protection (PIP) billing.

The States Affected by “No Fault” Auto Insurance Laws

Currently, there are 12 states in the United States that have no-fault insurance laws on the books. You need to be familiar with these laws if your practice is located in:

A) Florida

B) Hawaii

C) Kansas

D) Kentucky

E) Massachusetts

F) Michigan

G) Minnesota

H) New Jersey

I) New York

J) North Dakota

K) Pennsylvania

L) Utah

M) Puerto Rico (U.S. territory)

In these states, the auto insurer (sometimes called the “PIP insurer”) will pay for all medical bills up to the state’s “no fault” limit. After that, if the patient has health care coverage, the carrier — whether it is a private insurance company or a state program like Medicare or Medicaid — may cover some of the additional expenses. In the end, the remainder of the bill falls to the patient.

PIP Billing for Health Care Facilities

When it comes to PIP billing, it is important for health care providers to ensure proper communication between all parties. This can get complex quickly, especially when there are multiple patient encounters or when patients have more than one insurance provider. When miscommunications arise, it can lead to payment delays that increase your practice’s AR days and slow down your revenue cycle.

Therefore, you need to be sure that your practice is prepared to handle all of the complexities of PIP billing. Some of the most important aspects of the PIP billing process include:

A) Verifying the patient’s insurance eligibility

B) Confirming insurance benefits with each carrier

C) Negotiating with attorneys

D) Validating the accuracy of reimbursements

For small practices, it can be a major challenge to efficiently handle PIP billing while also staying on top of other billing needs. Therefore, many practices choose to outsource PIP billing to the experts at AnnexMed. Our PIP billing department has a great deal of experience with PIP billing for motor vehicle accidents, and we can streamline the process of PIP billing so that it does not take a toll on your practice’s revenue cycle. Contact us today to learn more about our services!

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