Question 1

What is MediClaim Billing Solutions?

Accepted Answer

MediClaim Billing Solutions is a Florida-based medical billing company that specializes exclusively in personal injury (PI) billing. Florida's Personal Injury Billing Specialists, we serve chiropractors, MRI centers, physical therapists, pain management clinics, orthopedic practices, and neurology providers across Florida. We handle the full revenue cycle — from claim submission and payment posting to Attorney Lien Management, denial follow-up, and reduction requests.

Question 2

What makes MediClaim different from general medical billing companies?

Accepted Answer

Most billing companies handle general health insurance billing. We focus exclusively on Florida personal injury cases — PIP (Personal Injury Protection), letters of protection (LOP), and multi-party attorney cases. That specialization means we know Florida Statute 627.736 inside and out, we understand the 14-day rule, and we know how to navigate the unique timelines and documentation requirements that PI cases demand. Our 98% clean claim rate and 21-day average reimbursement timeline reflect that expertise.

Question 3

What makes MediClaim Billing Solutions a specialist in personal injury billing?

Accepted Answer

MediClaim Billing Solutions specializes exclusively in Florida personal injury billing. We currently work with over 100 healthcare providers across the state.

Question 4

What types of providers does MediClaim serve?

Accepted Answer

We serve the full spectrum of Florida personal injury healthcare providers, including chiropractors, MRI and imaging centers, physical therapy providers, pain management clinics, orthopedic practices, neurology providers, and any Florida PI healthcare professional who treats auto accident or personal injury patients.

Question 5

What is PIP billing in Florida?

Accepted Answer

PIP stands for Personal Injury Protection. Florida is a no-fault state, which means every driver is required to carry at least $10,000 in PIP coverage. When a patient is injured in an auto accident, their own PIP insurance is billed first — regardless of who caused the accident. PIP billing follows strict rules under Florida Statute 627.736, including the 14-day rule (patients must seek treatment within 14 days of the accident) and specific documentation requirements. MediClaim specializes in PIP-compliant billing to maximize reimbursements and minimize denials.

Question 6

What is a Letter of Protection (LOP) and how does MediClaim handle it?

Accepted Answer

A Letter of Protection (LOP) is a legal agreement between a healthcare provider and a personal injury attorney. The provider agrees to treat the patient and defer payment until the personal injury case settles. LOPs are common in Florida PI cases where patients lack insurance or their PIP benefits are exhausted. MediClaim manages the full LOP lifecycle — tracking outstanding balances, coordinating with attorneys, monitoring case status, and ensuring your practice gets paid when cases resolve.

Question 7

What is the 14-day rule in Florida PIP billing?

Accepted Answer

Under Florida Statute 627.736, a patient injured in an auto accident must seek initial medical treatment within 14 days of the accident to be eligible for PIP benefits. If treatment begins after 14 days, the PIP claim will be denied. MediClaim ensures your documentation clearly establishes the treatment timeline so claims are not rejected on this basis.

Question 8

What happens when PIP benefits are exhausted?

Accepted Answer

Florida PIP coverage is limited to $10,000 ($2,500 for non-emergency conditions). Once PIP is exhausted, billing typically shifts to the patient's health insurance, a letter of protection with an attorney, or MedPay coverage if available. MediClaim coordinates this transition seamlessly so your practice continues to receive payment without gaps in the revenue cycle.

Question 9

How do I find a PIP billing company in Florida?

Accepted Answer

When searching for a Florida PIP billing company, look for specialists with exclusive personal injury focus — not general billing companies that handle PI as a sideline. Key criteria: proven experience with Florida Statute 627.736, a track record with LOP cases, a clean claim rate above 95%, and direct attorney coordination capabilities. MediClaim Billing Solutions — Florida's Personal Injury Billing Specialists — serves 100+ Florida PI providers with a 98% clean claim rate and 21-day average reimbursement. Call us at 1-800-576-5010 to discuss your practice.

Question 10

What is PIP denial management and why does it matter?

Accepted Answer

PIP denial management is the process of identifying, appealing, and recovering denied PIP claims. Florida PIP denials are common — insurers may deny claims for late filing, missing documentation, failure to meet the 14-day rule, or disputes over medical necessity. Effective denial management means catching denials quickly, identifying the root cause, and filing timely appeals with the correct supporting documentation. Every denial we receive is appealed aggressively until resolved.

Question 11

Can MediClaim help with PIP underpayment recovery in Florida?

Accepted Answer

Yes. Florida PIP underpayments are a significant revenue leak for many practices. Insurers sometimes pay less than the allowable amount under Florida Statute 627.736 — either through fee schedule disputes, incorrect reductions, or improper application of the 80% payment rule. MediClaim audits every payment against the allowable amount, identifies underpayments, and pursues recovery through the appropriate dispute and appeal channels.

Question 12

Does MediClaim handle PIP billing for chiropractors, MRI centers, and physical therapists?

Accepted Answer

Yes. MediClaim serves the full spectrum of Florida PI providers: chiropractors, MRI and imaging centers, physical therapists, pain management clinics, orthopedic practices, and neurology providers. Each specialty has unique coding, documentation, and payer requirements in the PI context — our team is trained on all of them. Whether you're a chiropractic practice billing PIP for auto accident patients or an MRI facility managing high-volume PI claims, we have the expertise to maximize your reimbursements.

Question 13

How does Florida PIP billing work for chiropractors?

Accepted Answer

Florida chiropractors bill PIP claims to the patient's auto insurance carrier after an auto accident. PIP pays 80% of reasonable chiropractic expenses up to $10,000 when a physician certifies an Emergency Medical Condition (EMC). The patient must have sought initial treatment within 14 days of the accident. Chiropractic services are reimbursed at 200% of the Medicare fee schedule under Florida Statute 627.736, and claims must be filed within 35 days of service. The insurer is then required to pay or deny the clean claim within 30 days.

Question 14

Can a chiropractor certify an Emergency Medical Condition (EMC) in Florida?

Accepted Answer

No. Under Florida Statute 627.736, only a physician (MD or DO) or an Advanced Registered Nurse Practitioner (ARNP) can certify an Emergency Medical Condition. Chiropractors cannot certify EMC status. This is critical because without an EMC certification, the PIP benefit cap drops from $10,000 to $2,500 — regardless of how much chiropractic treatment the patient receives. Chiropractors treating PI patients should coordinate with a referring physician who can evaluate and document EMC status at the initial visit.

Question 15

What CPT codes do Florida chiropractors use for PIP billing?

Accepted Answer

Florida chiropractors most commonly bill PIP claims using CPT 98940, 98941, and 98942 for chiropractic manipulative treatment (CMT), CPT 99202–99215 for evaluation and management, and CPT 97010–97530 for physical medicine modalities such as electrical stimulation, ultrasound, and therapeutic exercises. All codes must be supported by clinical documentation and must align with the Florida PIP fee schedule at 200% of Medicare. Bundling rules apply — some modality codes are automatically bundled with CMT codes by certain PIP carriers.

Question 16

Why are chiropractic PIP claims denied in Florida?

Accepted Answer

The most common reasons Florida chiropractic PIP claims are denied include: late filing after the 35-day deadline, failure to meet the 14-day rule, missing or incomplete clinical documentation, no EMC certification limiting the benefit to $2,500, medical necessity disputes triggered by peer review or independent medical examination (IME), incorrect fee schedule billing, and bundling errors on physical medicine modality codes. Most chiropractic PIP denials are preventable with proper documentation, accurate coding, and timely submission.

Question 17

How does Florida PIP billing work for MRI centers?

Accepted Answer

MRI and imaging centers bill PIP claims to the patient's auto insurance carrier for diagnostic imaging performed after an auto accident. PIP reimburses MRI services at 200% of the Medicare fee schedule under Florida Statute 627.736. MRI claims are among the highest-value PIP claims and are frequently subject to medical necessity challenges, pre-authorization disputes, and peer review. The 14-day rule applies — the patient must have sought initial treatment within 14 days of the accident — and claims must be filed within 35 days of the date of service.

Question 18

What are the most common reasons MRI PIP claims are denied in Florida?

Accepted Answer

Florida MRI PIP claims are most commonly denied for: medical necessity disputes (the insurer challenges whether the imaging was necessary), missing or inadequate physician referral documentation, failure to meet the 14-day rule, late filing after the 35-day deadline, incorrect CPT coding for the imaging service, and fee schedule billing errors. High-value imaging claims receive more scrutiny from PIP carriers — thorough documentation of the clinical indication for imaging is the primary defense against medical necessity denials.

Question 19

How long does PIP take to pay chiropractic and MRI claims in Florida?

Accepted Answer

Florida Statute 627.736 requires insurers to pay or deny a clean PIP claim within 30 days of receipt. MediClaim Billing Solutions achieves an average reimbursement timeline of 21 days from claim submission to payment for both chiropractic and MRI PIP claims. This faster-than-statutory timeline is the result of submitting clean, fully documented claims that move through the payer process without delays, additional information requests, or administrative errors.

Question 20

What documentation do chiropractors need to support a Florida PIP claim?

Accepted Answer

Florida chiropractic PIP claims require: a completed HCFA-1500 claim form with the accident date in Box 14, a signed Assignment of Benefits (AOB), an initial evaluation note documenting the mechanism of injury, physical examination findings, diagnosis, and treatment plan, SOAP notes for every treatment visit documenting the patient's current status and ongoing medical necessity, and consistent documentation of the accident date across all records. Template notes that lack patient-specific findings are a primary target for medical necessity denials and peer review challenges.

Question 21

What is the Florida PIP fee schedule and how does it affect chiropractic and MRI reimbursement?

Accepted Answer

The Florida PIP fee schedule sets the maximum reimbursable amount for each medical service billed under PIP. Under Florida Statute 627.736, PIP reimburses at 200% of the Medicare fee schedule for the geographic area where the service was rendered. For chiropractors, this applies to CMT codes, E&M codes, and physical medicine modalities. For MRI centers, it applies to diagnostic imaging CPT codes. Billing above the fee schedule does not increase reimbursement — it triggers automatic reductions. Billing below it leaves money on the table. Accurate fee schedule compliance is essential for maximizing PIP collections.

Question 22

What happens to chiropractic and MRI billing when PIP benefits are exhausted?

Accepted Answer

When a patient's PIP benefits are exhausted — $10,000 for EMC cases, $2,500 for non-EMC cases — billing for continued chiropractic or MRI services typically transitions to one of three options: (1) a Letter of Protection (LOP) with the patient's personal injury attorney, where the provider defers payment until the PI case settles; (2) the patient's health insurance, which may cover continued care subject to coordination of benefits rules; or (3) MedPay coverage, if the patient carries optional Medical Payments coverage on their auto policy. MediClaim manages this transition and tracks all active LOP cases through to settlement.

Question 23

How does PIP billing work for orthopedic practices in Florida?

Accepted Answer

Orthopedic PIP billing in Florida involves multi-payer coordination across PIP, health insurance, and attorney liens — often on the same patient. PIP covers the first $10,000 (or $2,500 without EMC certification) of medically necessary orthopedic care at 80% of the Florida fee schedule. Surgical procedures, diagnostic imaging, and follow-up care each have specific CPT coding requirements. When PIP is exhausted, orthopedic practices typically transition to a Letter of Protection with the patient's PI attorney. MediClaim manages the full orthopedic PIP billing cycle — from initial claim submission through attorney coordination and final settlement.

Question 24

How does PIP billing work for urgent care centers in Florida?

Accepted Answer

Urgent care centers treating Florida auto accident patients bill PIP under the same rules as other providers — claims must be submitted within 35 days of service, and the 14-day rule requires the patient to have sought initial treatment within 14 days of the accident. The most critical billing issue for urgent care is Emergency Medical Condition (EMC) certification: if the treating provider certifies an EMC, the patient qualifies for up to $10,000 in PIP benefits; without EMC certification, the cap drops to $2,500. Urgent care centers must ensure their documentation clearly supports the EMC determination to protect the patient's full benefit and the provider's reimbursement.

Question 25

What services does MediClaim Billing Solutions offer?

Accepted Answer

MediClaim offers eight core services: (1) Claim Submission — accurate, timely submission to PIP carriers and insurers; (2) Payment Posting — reconciling payments and EOBs; (3) Continuous Follow-Up — persistent denial management and appeals; (4) Provider Portal Management — credentialing and portal access; (5) Attorney Lien Management — full letter of protection tracking and attorney coordination; (6) Reduction Requests — negotiating medical bill reductions at settlement; (7) Billing Consulting — revenue cycle audits and strategy; (8) Practice Management — KPI tracking, staff training, and operational support.

Question 26

What is MediClaim's clean claim rate?

Accepted Answer

MediClaim maintains a 98% clean claim rate — meaning 98% of claims we submit are accepted and processed on the first submission without errors or rejections. The industry average is significantly lower. Our clean claim rate is the result of thorough documentation review, Florida PIP expertise, and rigorous pre-submission auditing.

Question 27

How quickly does MediClaim get providers reimbursed?

Accepted Answer

Our average reimbursement timeline is 21 days from claim submission to payment. Florida PIP law requires insurers to pay or deny clean claims within 30 days, and our 21-day average reflects our ability to submit clean, complete claims that move through the payer process quickly.

Question 28

How does MediClaim handle denied claims?

Accepted Answer

Denied claims are a normal part of PI billing — but they should never be the end of the road. MediClaim's continuous follow-up service tracks every denial, identifies the root cause, and files timely appeals with the supporting documentation needed to overturn the decision. We do not let claims age out or fall through the cracks.

Question 29

Does MediClaim handle reduction requests at settlement?

Accepted Answer

Yes. When a personal injury case settles, attorneys often request medical bill reductions to maximize the client's net recovery. MediClaim manages the reduction request process on your behalf — reviewing requests, negotiating appropriate reductions, and ensuring your practice is treated fairly while maintaining strong attorney relationships.

Question 30

How do I get started with MediClaim Billing Solutions?

Accepted Answer

Getting started is simple. Call us at 1-800-576-5010, email us, or fill out the contact form on our website. We'll schedule a consultation to review your current billing workflow, identify revenue opportunities, and build a customized plan for your practice. There's no long-term contract required to get started.

Question 31

Does MediClaim work with practices outside Florida?

Accepted Answer

MediClaim Billing Solutions currently specializes in Florida personal injury billing. Our expertise is specifically built around Florida's no-fault PIP laws, Florida Statute 627.736, and the Florida PI legal and insurance landscape. Providers outside Florida should contact us to discuss their specific situation.

Question 32

Can MediClaim help a practice that is already billing PI cases but wants to improve results?

Accepted Answer

Absolutely. Our Billing Consulting service is designed exactly for this situation. We audit your current workflow, identify revenue leaks and denial patterns, and build a strategy to improve your clean claim rate and accelerate reimbursements. Many practices come to us after years of leaving money on the table with a generalist billing company.

Question 33

How does PIP billing outsourcing work with MediClaim?

Accepted Answer

PIP billing outsourcing with MediClaim is straightforward. We integrate with your existing EHR or practice management system, take over the full billing workflow, and handle everything from claim submission to final payment posting. You retain full visibility through our provider portal. Most practices are fully onboarded within 48 hours. There's no long-term contract required — we earn your business through results.

Question 34

Can MediClaim help maximize PIP revenue for my Florida practice?

Accepted Answer

Maximizing PIP revenue requires three things: clean claims submitted on time, aggressive denial follow-up, and accurate payment reconciliation to catch underpayments. MediClaim's 98% clean claim rate directly translates to higher collections. We also audit every payment for underpayments and pursue recovery when insurers pay less than the allowable amount under Florida Statute 627.736.

Question 35

What is PIP revenue cycle management and does MediClaim offer it?

Accepted Answer

PIP revenue cycle management (RCM) is the end-to-end process of managing a Florida PI practice's billing from patient intake through final payment — including claim submission, payment posting, denial management, appeals, LOP tracking, and reduction request negotiation. MediClaim offers full PIP RCM services for Florida providers, handling every step of the cycle so your practice maximizes collections with minimal administrative burden.

Frequently Asked Questions

About MediClaim Billing Solutions

Florida PI Billing & PIP

Chiropractic & MRI PIP Billing

Services & Process

Getting Started

Still have questions?

Florida PIP Billing FAQ — MediClaim Billing Solutions