PIP Question

[Guest guest]

Hello All. I had something weird come up at the office today. My secretary just got off the phone with Geico regarding an MVA that we've been treating for the past 3 months. The adjuster advised us that the patient chose to go through the other carrier for their medical rather than their own PIP. Has anyone ever heard of this? Can patients do that? Do I just bill them like I would his PIP and expect to get paid on time or do I have to wait for settlement? Can we have the patient call Geico to switch it back? Thanks again for all your help, docs!

Cluen, DC

Cluen, DCAuto & Work Injury Center3311 NE MLK Blvd. Suite 202Portland, OR 97212503-282-4878

[Guest guest]

This really isn't all that wierd in the realm of auto cases.

Sometimes a patient for whatever reason feels they don't want to make a claim on their own policy. Sometimes they feel it may negatively affect their policy or perhaps it wasnt their vehicle yadayadayada.

You must wait for settlement if they choose this route. Of course you can try to convince them to use the PIP and try to convey to them that thats in their best interest. If they (and they should) sign a lien and the settlement doesnt cover your bill they are responsible. This is a higher risk than if they just used PIP.

Dr. Cluen, I notice you opened practice not far from me a couple years ago. Have you been in Oregon long? The world of PIP and WC can get convoluted at times.

Take Care,

Joe

ph Medlin D.C.Spine Tree Chiropractic1607 NE Alberta St. PDX, OR 97211www.spinetreepdx.com

PIP Question

Hello All. I had something weird come up at the office today. My secretary just got off the phone with Geico regarding an MVA that we've been treating for the past 3 months. The adjuster advised us that the patient chose to go through the other carrier for their medical rather than their own PIP. Has anyone ever heard of this? Can patients do that? Do I just bill them like I would his PIP and expect to get paid on time or do I have to wait for settlement? Can we have the patient call Geico to switch it back? Thanks again for all your help, docs!

Cluen, DC

Cluen, DCAuto & Work Injury Center3311 NE MLK Blvd. Suite 202Portland, OR 97212503-282-4878

[Guest guest]

So here's the deal as I experience/understand it:

Year One--The injured patient's PIP covers all appropriate and necessary care. Including supplements, I might add. You bill the primary PIP company and get paid as you go along.

Year Two--New Rules of the Game:

Starting on Day 366: It becomes a "Third Party" claim with the offending driver's auto insurance company.

The rub is this: You are able to provide treatment and the 3rd party insurance company will cover your costs.

HOWEVER, you will NOT be paid as you go along. Payment will be provided only whenl the claim is completely finished and "Settlement" occurs. At that time, the patient signs a final agreement with them, bills are paid and settlement is provided and the claim gets closed permanently.

Soooo, that said, you MUST protect yourself with an "Irrevocable Lien" signed by your patient and submitted to the Third Party insurance company. Send it CERTIFIED MAIL

This lien says that the patient understands that they are responsible for all cost, regardless of whether or not there is a final settlement and that THE THIRD PARTY INSURANCE COMPANY MUST PAY YOU BEFORE FINAL FUNDS ARE DISBURSED TO YOUR PATIENT.

I explain to my patients that I am essentially making them a LOAN IN GOOD FAITH. Since I am not a bank, I ask them to sign the lien in order not to put myself in financial risk. I have never had a patient balk or complain. They understand that I am providing a necessary service and that I should be paid at the end. I would be happy to share the lien document I use. It's a hybrid lien based on parts of other liens I 'stole' from several docs. LOL

I'm submitting this to you AND to the list serve in the event that there is anything in my explanation that is incorrect or if there are any 'rules of engagement' that might have changed while I was having so much fun treating patients!

Hope this helps.

Ann , DC

PIP question

Hi All

PIP insurers frequently tell patients they can get medical coverage

for their injuries for two years after their accident. I recently had

a guy whose accident was about 13 months ago. He has been in constant

contact with the claim rep, telling her that he was still sore and he

finally decided to get treatment.

So, is the process the same as a normal PI case or are there special

circumstances I need to be aware of?

Thanks

Don , DC

Corvallis

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