The double billing of $450 for one date of service with multiple CPT codes ultimately led to the granting of defendant’s Motion for Final Summary Judgment.
Earlier this year the Palm Beach County Court addressed the case of Foundation Chiropractic Clinic, Inc. v. State Farm Mutual, involving PIP benefits.
The undisputed facts involved a motor vehicle accident on November 1, 2010. Foundation Chiropractic Clinic, the plaintiff, sent a May 23, 2011 pre-suit demand letter to defendant State Farm, which was received on May 25, 2011. Plaintiff requested $7,310, with various discounts, for allegedly overdue PIP benefits in accordance with Florida Statute §627.736(10). Medical treatment was rendered between January 3, 2011 and March 9, 2011.
The real trouble began during a deposition of Dr. Charles Mitzelfeld on September 10, 2012. During his testimony, Dr. Mitzelfeld acknowledged that a $450 service rendered on January 6, 2011, was incorrectly double-billed as $900.
Initial Court hearings took place on February 19, 2013, at which time the court ordered an abatement until March 21, 2013 to grant plaintiff time to comply with the Statute.
Key facts emphasized by the Court included but were not limited to the following:
1) The pre-suit demand letter was defective, since:
a) Demand letters must strictly adhere to Florida Statute §627.736(10)
b) PIP claims require medical billing precision
c) The $450 double-billing means the amount was never due and payable
2) Dismissal, not abatement, was the appropriate remedy for the facts of the case
Accordingly, the Court granted defendant’s Motion for Final Summary Judgment.
The case is Foundation Chiropractic Clinic, Inc. v. State Farm Mutual, Case No. 502011SC006973XXXXMB(RJ), Claim No. 59-A670-488, heard in Palm Beach County Court. John M. Gioannetti was the lead attorney for Roig Lawyers. The case initially began as a small claim. Click on the link to read the Amended Final Judgment for the Defendant.