Motor Vehicle Accident and PIP Billing for Pain Management

What does MVA and PIP billing involve?

Accident billing starts at intake, when we record the auto carrier, claim number, adjuster and policy limits. From there we verify remaining PIP benefits, request precertification, bill to the state fee schedule, switch to secondary coverage when PIP runs out, and work with the patient's attorney through settlement.

• Identifying the auto carrier, claim number, adjuster and policy limits at intake
• Verifying remaining PIP benefits and whether health insurance is primary
• Requesting precertification or Decision Point Review before procedures
• Billing to the applicable state fee schedule
• Switching to secondary coverage when PIP benefits are exhausted
• Coordinating records and billing statements with the patient's attorney
• Tracking letter of protection and lien cases through settlement

How does New Jersey PIP billing work?

New Jersey is a no-fault state, so auto injury treatment is billed first to the patient's own PIP coverage. NJ carriers use Decision Point Review Plans, pay according to the state's medical fee schedule, and require internal appeals before a dispute can go to PIP arbitration. We handle each of those steps for New Jersey practices.