Auto Claims - Best Practices
Through years of experience in managing account receivables for therapy practices across the country, WebPT has developed a series of best practices in A/R management.
Auto Claims: Tort Liability Insurance- Fault States
Physical Therapy practices often treat patients who have injuries sustained from auto accidents. In general, there are two types of insurance policies that patients carry and the type of coverage they have is governed by the state they live in. There are Fault States (Tort Liability Insurance) and No-Fault states (No-Fault Insurance.) The major difference between these two types of policies is whether the policyholder’s insurance carrier pays first-party benefits, regardless of which driver was at fault. The difference also determines how you pursue outstanding claims due by the auto insurance.
In Fault States, if after 90-days the auto insurance has not issued a payment or responded to our inquiries regarding the outstanding balance, it is RevFlow’s policy to transfer the outstanding insurance balance to the patient and to send the patient a letter explaining that their insurance has not paid for their claims. There is a Patient Letter available in RevFlow titled “Auto Ins has not Paid” that can be used for this. This is only done after an attempt has been made to resolve the balance with the insurance carrier. This policy ensures that the patient is notified timely that their insurance has not issued payment.
No-Fault States have different rules and policies regarding outstanding medical claims. To find out if your state is Fault, or No-Fault, you can search online for a list of No-Fault states and research billing rules for your state.