PIP Department Protocol

👉 Everyone is to follow the following protocol for the PIP Dept.

The PIP Dept should be receiving only the following EOB’s from the team leads:

• Patient has missed IME’s
• Surgery denials / and under payments for surgeries and procedures ONLY
• PIP exhaustions / Policy Max ( it’s the same thing people)
• Denial stating patient isn’t covered under specific policy for PIP
• Denials for IME cut off’s
• Benefits Terminated

☝ If benefits are terminated it DOES NOT MEAN that the policy is exhausted – IT CAN STILL BE APPEALED AND ARB’D do not bill health insurance secondary.

☝ Please do not give PIP Dept health care primary EOBS that is the team leads responsibility to handle and bill accordingly.

👉 DO NOT INTERRUPT the PIP department at any time unless there is literally A HOUSE ON FIRE! - DO NOT come to their desk. Please send them an email ( EMERGENCIES ONLY ) and they will respond to you in a timely manner.

Here is the link to the PIP fee schedule: https://www.state.nj.us/dobi/pipinfo/aicrapg.htm

☝ The PIP dept doesn’t need to be interrupted to Fee schedule a bill. ANYONE can do this.

Questions??? Please come see me, Carmen Medina - Ruiz, Team Lead.

Thank you!

✉ cmedina@spsrcm.com
☎ (855)777-1056

PIP/Attorney Negotiations

PIP department has specific guidelines per attorney and client.

Commercial and Blue Cross

• All Surgeries - Supervisors
• Office Visits - Team Leads

Workers' Compensation

Do not negotiate workers' compensation!