What does ERISA mean?

ERISA stands for Employers Retirement Income Security Act. The ERISA act was designed to establish Federal standards for employee retirement and benefit plans. If an employee is covered by a health insurance plan that falls into the ERISA category, then federal laws take precedence over state laws when it comes to the coordination of benefits for patients receiving medical care after an auto accident. What does that mean in plain English? If your patient has an ERISA health plan, than you can access the entire $8000 of available PIP money to address your bill! We have contacts and relationships at most of the major health insurance companies, and we can assess whether your patient’s plan falls into the ERISA category very quickly.

Learn more about ERISA health insurance plans 

 


Masshealth and Medicare

Just like ERISA health plans, patients covered by Masshealth, Masshealth affiliated plans or Medicare also fall outside of the state’s coordination of benefits guidelines. This means that you have access to the entire $8000 of PIP to address your bill!


8K PIP Deductible headaches (beware of the Gekko!)

We have all seen those humorous television commercials where talking reptiles, cavemen and various other cartoon like characters pitch cheap monthly premiums for auto insurance. While they might actually save customers a few dollars each month, those discount plans are usually missing the entire $8000 worth of PIP coverage. Chiropractors and Physical therapists who treat patients with 8K PIP Deductibles face the same kind of headaches as those caused by the 2K PIP exhaust roadblock. The 8K PIP Deductible roadblocks are not as numerous as the 2K PIP exhaust roadblocks, but we execute the same perfected lien service for these claims to maximize the chance of payment from the patient’s bodily injury settlement.


Medpay

Surprisingly, a greater number of auto policies in Massachusetts have a “medpay” provision that is available to pay medical bills related to auto accidents. Unlike PIP coverage, medpay is not subject to the same coordination of benefits guidelines that limit payment when there is health insurance. We can identify whether there is a medpay provision on your patient’s auto insurance policy quickly through our network of auto insurance adjusters, and we can access it quickly to address your unpaid bill.


First Day Billing for Auto Insurance medical claims

We have been performing first day medical billing for chiropractors and physical therapists who treat patients injured in auto accidents since 1998. We have state of the art medical billing and claim tracking software, which, when combined with our extensive experience working only with auto insurance claims, helps to maximize our client’s cash flow. If you currently outsource your auto insurance claims, or you were considering outsourcing your auto insurance claims, we will match or beat the price of any competitor.


2K PIP Exhaust Roadblocks

Ever since the Massachusetts Health Care Reform Law required residents  to purchase health insurance, inner city medical providers who treat patients injured in auto accidents have faced treacherous road blocks to their cash flow. This is because patients with health insurance who treat outside of their HMO network are only entitled to the first $2000 worth of Personal Injury Protection (PIP) on their automobile insurance policy. In years past, patients without health insurance were able to utilize the entire $8000 worth of PIP coverage to pay for medical treatment after an auto accident. As a result, chiropractors and physical therapists are left with very high balances with no prospect of obtaining payment from no fault auto insurance.

We don’t promise miracles, but we do have solutions that have helped our clients break through that 2K PIP exhaust barrier.

Most chiropractors and physical therapists I meet with complain about 2K PIP exhaust barriers more than anything else. Patient attorneys rarely go out of their way to offer payment from the bodily injury claim settlement. Some offices have a “lien” that is signed by the patient at the outset of treatment, but they rarely result in compelling the patient or his/her attorney addressing their unpaid balance.


Accelerate Your Cash Flow

We're a unique organization dedicated exclusively to the recovery of unpaid PIP (personal injury protection) claims for medical providers throughout New England. Since 1997 we have recovered over $25,000,000 worth of delinquent claims for medical providers who treat patients injured in motor vehicle accidents. Get started with our "Quick Start Collection Sheet"

Are you tired of writing off small balances for your auto claims?

For years Massachusetts PIP insurers have been paying physical therapist and chiropractor bills at "usual & customary" rates.

A recent court ruling found that the databases the PIP carriers utilized were unreliable and did not provide accurate information regarding “usual & customary” fees.

We can help you recover these balances on claims up to 6 years old! In recent weeks we have been negotiating settlements worth thousands of dollars for our clients.

Contact us today to learn more