Best Practices — 20 February 2013
Exhausted PIP Benefits

Personal injury protection (PIP) benefits are the insurance policy’s coverage source for compensation of medical care received after a car accident. Injuries from car accidents can be subject to a sizeable amount of PIP benefits.

At times, physical therapists working on lien with personal injury cases may experience long delays in receiving payment. Sometimes these delays are a result of diminished funds instead of the insurance company’s fault. If this is to happen, the responsibility to pay for medical treatment can be up for litigation. Once the case is resolved, the funds are now available for disbursement. However, by that time, you might have to wait in line as one of the many healthcare providers waiting to get paid.

After hospital fees, physical therapy may be the largest medical fee owed by the patient. Many elements influence the amount of treatments needed for each PIP case. On average, the patient is recommended to undergo rehabilitative therapy three to four times a week for about four to six weeks. This process can become very expensive after some time.

Other healthcare providers may be reimbursed prior to physical therapists because the rehabilitative process can be lengthier. For example, an imaging clinic that processes the MRI taken on the day of the accident will be reimbursed before rehab expenses. Therapeutic treatments usually occur much longer after an MRI has been taken; therefore, the patients PIP benefits may be diminished before the physical therapist has been reimbursed.

To be best prepared for a situation like this, it is best to contact the patient’s lawyer to discuss a payment plan in case PIP funds become inaccessible. The patient may choose to use health insurance to cover additional treatments that were not reimbursed due to a lack of PIP funds. If the patient chooses to use their health insurance, they might not want to be responsible to pay for copays and deductibles until the case settles. As the medical provider, you must guarantee that the patient’s lawyer is mindful of the patient’s outstanding medical balance. If the PIP benefits are exhausted before full payment is received, you should periodically remind the attorney of the remaining balance.  Monthly statement sent to the attorney’s office is recommended.

You must ensure that the patient’s attorney is aware of the patient’s outstanding balance. Upon the exhaustion of the patient’s PIP benefits, you should make it a practice to periodically inform the attorney of the patient’s outstanding balance. Ideally, send monthly statements to the attorney to update him on the client’s balance.

When communicating with personal injury attorneys, most are in need of efficient doctors who will not delay their case. So when dealing with PIP and other time sensitive matters, these attorneys have sought of Power Liens Preferred Providers. These doctors found on the website directory www.PowerLiens.com have shown to be the most trustworthy offices on the directory which happens to be the largest directory of physicians working on a lien.

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