What are the most common reasons that insurance carriers use to deny or underpay bills?

After an accident, it is common for insured people to assign their PIP benefits under their applicable insurance policy to a medical provider in exchange for medical treatment. The dedicated team at Revenue Recovery Firm represents your interests as a medical provider and a business at the same time. We work to recover every dollar you have been owed in the past five years.

Denials

Insurance company denials often occur when there is a billing error. Insurance companies can be aggressive, using denials as a tactic to deter attention from the PIP benefits.

Underpayments

Insurance carriers may reduce payment for PIP claims by a small amount, assuming that most medical providers will not bother to pursue it.

Exhaustion of benefits

One of the most common reasons a carrier will deny a claim is exhaustion of benefits. For example, if a carrier pays a full $10,000 in benefits to providers making claims, they close the book on later claims and allege that services were rendered after benefits were consumed.

Fee schedules

Florida statute allows insurance carriers, in certain cases, to use fee schedules to pay medical bills. There are strict rules as to when a carrier may use a schedule and when they may not. If a carrier does not follow the rules precisely, they are responsible to pay the legitimate amount owed.

Misinterpretations when taking out the policy

Certain insurance carriers deny claims on the basis that there were misconceptions in how the policy was executed.

Insurance companies can be aggressive in how they deny or underpay bills. At Revenue Recovery Firm we know that the PIP statute contains a hierarchy of who should be paid and in what order, and we work to exhaust the benefits available in each case.

Who Revenue Recovery Firm represents

Radiologists
Physical Therapists
Urgent Care Centers
Chiropractors
ER Physicians
Trauma physicians
Psychiatrists
Orthopedics
Neurosurgeons
General Surgeons
Physiatrists