Friday, June 11, 2010

Auto insurance deny the claim - PIP benefits exhausted

WC Denials - PIP BENEFITS EXHAUSTED 

    This rejection is common in Auto insurance claim.  PIP stands for Personnel Injury Protection. This rejection indicates that the carrier’s liability towards PIP of the subscribers has been exhausted.

    Action: When you get this rejection, see whether the patient has any secondary coverage like Medical coverage ex. Medicare united, Medicaid, etc. if yes, check with the carrier whether they will be processing the claim as primary if the primary rejection is attached and sent to them. If no, then the patient has to be billed.

2 comments:

  1. can you still bill the remaining balance after insurance processes their pmt to the pt? we would get the full amount if the auto was paying. if ins pays then they require a contracted write off so we lose money.... should we have pt pay then let them get reimbursed by their ins?

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