Auto Insurance Claims: Taxi billing, claims advice, Florida PIP

Question
QUESTION: The facility I work for is getting ready to start billing PIP policies for the pick and delivering of the patients to our clinic. Is there a limitation as to what can be billed to the patients auto carrier? I know that in the past we have also had to provide sufficient documentation such as mileage determination and such; can you also please elaborate on any further documentation and/or billing requirements that you would be aware of? Thanks,

Heather

ANSWER: Hello Heather,

You do not mention what state you are in, so let me begin by informing you that PIP is governed by statutes and those statutes generally address the limitations and documentation necessary to bill for transportation.  In fact, you may not be able to bill at all, depending on the statutory requirements, or there may be a requirement that the patient submit a receipt for payment.

So, first, your facility must become familiar with the statutory requirements for your state.  In any event, you would certainly need to provide detailed documentation as the process involves the utilization of the patients' benefits.

I am confused with your reference to "taxi billing".  If the patient is paying for a taxi to travel to and from your clinic, you would not be entitled to any compensation.  That would be a matter between the patient and the insurance company.

Hope this helps.

Jane Pytel
http://www.SolutionsForYourInsuranceClaim.com

---------- FOLLOW-UP ----------

QUESTION: Jane,

I am so sorry for not including that earlier..we are located in Florida. If possible, can you help me locate any information within the statues to better help me with the requirements; I am not sure what you experience is within our locality.

To answer your question, taxi billing is just the term for which we use in the office to describe the service that we are providing to the patient. We are hiring a cab driver to provide private transportation to our patients. Which leads me into another question; do we need to have additional liability coverage from our malpractice to add for this type of service or will the drivers liability policy cover them?

Thanks for your prompt response to my question

Answer
The governing statute in Florida is F.S. 627.736.

I do not believe a provider can add charges for transportation.  To my knowledge, the only transportation approved for direct payment under the statute is emergency transportation.

An injured party can submit transportation costs for reimbursement, accompanied by the appropriate verification. Authorized payment would go directly to the patient.

If your clinic has an attorney, I would suggest you verify this information, however I am not aware that you can bill directly for transport. Florida law takes patients' benefits very seriously. Understand that transport billings come out of those benefits.  Ideally, the benefits should be used only for treatment.

As to liability, transport would not be a part of your malpractice insurance.  Liability for transport would fall under the terms and conditions of your business auto insurance policy. Your agent could provide you with case specific advice.

Jane Pytel
http://SolutionsForYourInsuranceClaim.com