09 June 2022

Why Does Speed Matter? The timely billing of a no-fault insurer.

One of the major changes that occurred in the recent amendment of the no-fault act gave consumers the option to choose the level of coverage for their no-fault benefits. These coverage levels include:

  1. $50,000.00 for drivers with Medicaid
  2. $250,000.00
  3. $500,000.00
  4. Unlimited
  5. Consumers with Medicare can opt-out of no-fault medical benefits

When encountering an injured person who has selected a limit on their coverage it creates the question, “who will be paid first?” There has been no definitive answer to this question. However, if multiple healthcare providers have treated an injured person the first in first out principle will better position a healthcare provider to ensure payment of its charges.

The no-fault billing timelines created in the no-fault act reinforce the notion that healthcare providers will be paid in the order in which an insurer receives a healthcare provider’s bill. These timelines are also critically important to ensure timely payment of a healthcare provider’s charges. Under the act, an insurer has 30 days to pay a healthcare providers bill if the healthcare provider has billed the insurer within 90 days of treatment. If an insurer fails to make the payment within 30 days, a healthcare provider may be entitled to penalty interest. If a healthcare provider fails to bill the insurer within 90 days, an insurer has 90 days to make a payment before the bill is considered overdue.

Speed matters as delays in billing the proper insurer can cause a healthcare provider to miss the opportunity to be paid its charges and possible penalty interest.

If you have any questions about this or any other medical recovery issue, please contact the author or any of our medical provider reimbursement counsel.