Floridians’ mandatory no-fault insurance is supposed to guarantee up to $10,000 in coverage of their medical treatment for accident-related injuries. But the healthcare professionals who provide that treatment have come to know better.

 

The insurance industry has made a game of denying and shortchanging legitimate medical bills, and much of the time, claims are rejected over the most trivial – and baseless – technicalities. In fact, more than half of the claims submitted to the largest auto insurance carriers come back with some reduction tied to a technical error.

 

That’s why it is imperative that doctors, chiropractors, diagnostic professionals and hospital billing personnel are trained on how to fill out claim forms filed under their patients’ Personal Injury Protection coverage. If you’re not, you could be losing out on hundreds, even thousands, of dollars per claim – money you deserve.

 

Want an idea of how easy it is to get your valid claim rejected or reduced?

 

Sometimes, all it takes is checking the wrong box on what kind of a claim you’re filing. Or putting your signature in the wrong place. Even making a minor math error – whether it’s in the insurance company’s favor or not – is enough to get the claim rejected out of hand. Failure to use the right modifier in notifying the insurer that the treatments listed were performed on separate injuries, so that it doesn’t look like redundant therapies were used wastefully, will get your claim denied every time, too.

 

Don’t feel safe in the assumption that your copious treatment notes, included as required along with the claim form, will clear things up, either. Many times, the billing company will say it never received them from the insurer’s claims processing staff. And don’t expect the company to call to clarify an obvious mistake or omission before rejecting the claim. These insurers know what they’re doing, and rejecting claims based on the tiniest technicalities is gold for them.

 

And if a disastrous PIP "reform" measure currently advancing through the state House prevails, this anti-business climate will only get worse.

 

But you have options to protect your business from this gamesmanship. Legal professionals like those at Ellis, Ged & Bodden hold regular training workshops to give medical and diagnostic professionals the tools and the knowledge they need to submit these important forms properly every time. Having your Explanation of Benefits files routinely audited will also flag rejections resulting from baseless technicalities, allowing your trusted legal team to fight the unfair denials and help you recover what’s rightfully yours.

 

You have a right to be paid every dime you earned in treating your patients’ accident injuries, and such meaningless technicalities shouldn’t get in the way. Be knowledgeable, be prepared and fight for the money you rightly deserve.