Personal Injury and Auto Accident Billing Services
Personal injury billing services for providers who treat accident patients: PIP and no-fault, med pay, letters of protection, workers’ comp and health insurance coordination. BilNow bills each claim to the right payer and tracks every open balance until it is resolved.
98% First-Pass Claim Rate
Personal Injury Billing Services
Of Collections, No Setup Fee
No setup fee · No long-term contract · HIPAA-trained staff
Personal Injury Billing Services for Auto Accident and Injury Providers
Accident billing is not routine claim work. One patient can have several possible payers, an attorney involved and a balance that stays open until a case resolves. BilNow bills these claims for practices that regularly treat injured patients and tracks each case from the first visit to the final payment.
Chiropractic and rehab clinics
Visit-based care billed to PIP, med pay, a health plan or under a letter of protection. See our chiropractic billing services.
Orthopedic and spine practices
Consults, injections and procedures that may go to PIP, a lien or health insurance. See our orthopedic billing services.
Pain management and imaging
Higher-charge services where itemized bills and causation notes matter most.
Primary and urgent care
First visits after an accident, which set the accident date, payer and diagnosis that later providers rely on.
Who Pays First: PIP, Med Pay, Liability and Health Insurance
Several coverages can apply to one accident, and the order of payers varies by state and by policy. Before the first claim goes out, we confirm the order for each patient using the accident date and the patient’s auto and health policies.
| Payer | What it is | Billing note |
|---|---|---|
| PIP / no-fault | Auto coverage that pays the patient’s medical bills regardless of fault, up to policy limits. | Often billed first where available. Limits, forms and deadlines are set by the state. |
| Med pay | Optional auto coverage that pays medical bills regardless of fault, usually with lower limits. | Policy terms decide whether it pays before or after health insurance. |
| Third-party liability | The at-fault driver’s insurer, reached through a claim or lawsuit. | Pays when the case resolves, so care is often billed under a letter of protection until then. |
| Health insurance | The patient’s own health plan. | May be primary, secondary or excluded for accident care, depending on state law and plan terms. |
We record the confirmed order and recheck it when a new policy appears. Patients should ask their attorney or insurer how their own coverage applies; BilNow does not give legal advice.
Letters of Protection and Medical Liens: Treatment Before Settlement
A letter of protection (LOP) is a written agreement, usually signed by the patient’s attorney, under which the provider waits to collect until the case resolves, with payment expected from any settlement. A medical lien is a claim against settlement proceeds. Some states have lien statutes that set how liens are filed and paid, and others rely on the agreement between the parties. The two are not the same thing.
Either way, payment usually depends on the outcome of the case, and the patient’s responsibility for the bill depends on the document and state law. Please consult your attorney about how an LOP or lien works for your practice. BilNow does not give legal advice and cannot promise any recovery amount.
For every LOP or lien case we record the attorney, case number, agreement date and each charge, so your records match what the attorney receives.
Workers’ Compensation Claims: Fee Schedules, Claim Numbers and Forms
Work injuries are billed to the employer’s workers’ compensation carrier rather than the patient’s health plan, and the rules are set state by state.
Claim identifiers
Claim number, date of injury, employer and the adjuster or carrier contact. Without them the bill cannot be matched to a claim.
State fee schedules
Many states set what a carrier pays for each service, and the amounts often differ from commercial rates.
Forms and reports
Many states accept the CMS-1500, while some require their own forms. Carriers often also want a report showing work status and how the injury relates to the job.
Authorization and networks
Some states use utilization review, treatment guidelines or approved provider networks that apply before care is billed.
We confirm that the claim is accepted and check authorization and the fee schedule before billing. Our prior authorization services team handles approvals where they are required, and enrollment on approved provider lists or networks falls under our medical credentialing services.
Documentation Attorneys and Carriers Request, and Records Requests
In injury cases the chart is evidence. Attorneys and adjusters read it for what happened, what was treated and what it cost.
Causation
The accident date and mechanism of injury, the patient’s history, and findings tied to the accident.
Treatment plan
Diagnoses, visit frequency, goals, objective measures and re-evaluations that show why care continued.
Itemized bills
Each CPT or HCPCS code by date of service, with charges, payments and adjustments.
Narrative reports
Written opinions on diagnosis, medical necessity and prognosis, prepared by the treating provider when requested.
Records requests should be checked before anything is released. Release generally needs the patient’s signed HIPAA authorization, unless the law allows disclosure for another purpose, such as payment or workers’ compensation as state law requires. Our HIPAA-trained staff log each request, confirm the authorization or legal basis, and send only what is needed.
Medicare Secondary Payer Rules in Accident Cases
When a Medicare patient is hurt in an accident or on the job, Medicare is generally not the first payer for accident-related care. Auto and no-fault insurance, liability coverage and workers’ compensation usually pay before Medicare. This is the Medicare Secondary Payer (MSP) rule.
If the other payer will not pay promptly, Medicare can make a conditional payment, which must be repaid from any settlement or judgment. For liability claims, Medicare defines promptly as 120 days from the earlier of the claim or lien filing or the date of service. After that, a provider chooses between billing Medicare and continuing to pursue the liability claim or lien.
We ask every Medicare patient about accident and work injuries at intake, mark the claim accordingly and keep the primary payer’s response on file. Questions about a patient’s Medicare repayment obligations at settlement belong with the patient’s attorney.
Timely Filing and Common Denials in Accident Claims
Some no-fault programs give providers only weeks to bill. New York’s no-fault rules, for example, call for proof of claim within 45 days of the date of service. Other states differ, so we track a bill-by date for each service. Our timely filing limits guide explains how these deadlines work.
Late submission
The bill reaches a no-fault or comp payer after its window. We track bill-by dates from each date of service.
Wrong payer
The claim goes to health insurance when PIP or comp should pay first, or the reverse. We confirm the order before billing.
Missing claim data
No claim number, accident date or adjuster, so the payer cannot match the bill. We collect them at intake.
Medical necessity
The carrier disputes treatment length or frequency. We pair bills with treatment plans and progress notes.
Fee schedule reductions
Payment is cut to a state or policy schedule. We check amounts against the schedule and appeal errors.
Benefits exhausted
The PIP or med pay limit is used up. We track what remains and move the balance to the next source of payment.
When a denial arrives, our denial management services team works the appeal with the records the payer asked for.
Settlement Reductions, Balance Tracking and How Our PI Billing Workflow Runs
Many injury cases close with a request that providers reduce their balance. That decision stays with your practice, usually in talks with the attorney, and no one can promise a recovery amount. We keep the numbers accurate: dated balances, itemized bills and a record of every reduction.
Intake and payer order
We capture the accident date, claim numbers, attorney and every policy, then confirm which payer is first.
Verification and authorization
Eligibility is checked and approvals are in place before treatment is billed.
Coding and charge capture
Visit notes become itemized charges with accident indicators and diagnoses.
Claim submission
Claims pass payer-specific edits before they are sent, which supports our 98% first-pass claim rate.
Denials and follow-up
Every denial is worked, which keeps denials under 5%.
Case tracking and reporting
You receive open balances by case, attorney and age, and updates when a case settles.
BilNow charges 2.7% of collections. There is no setup fee and no long-term contract, so you pay when your practice gets paid. Our HIPAA-trained staff work inside your existing system, and we support more than 100 EHRs.
Personal Injury and Auto Accident Billing FAQs
What do personal injury billing services include?
Personal injury billing services cover the revenue work for accident and injury patients: confirming which payer is first, coding and submitting claims to PIP, no-fault, med pay, workers’ comp or health plans, billing letter of protection cases, answering attorney and carrier requests, and following up on denials. BilNow also tracks each open balance by case and attorney, so you can see what is still outstanding.
Who pays first after an auto accident: PIP, med pay, liability or health insurance?
It depends on the state and the policies, so we confirm it for each patient. In no-fault states PIP often pays first, med pay is an optional add-on with lower limits, and the at-fault driver’s liability insurer pays later through a claim or settlement. Health insurance may be primary, secondary or excluded for accident care. We check the accident date and policy terms and record the payer order in the account.
What is a letter of protection, and how do you bill it?
A letter of protection is a written agreement, usually from the patient’s attorney, that the provider will wait for payment until the case resolves. A medical lien is a claim on settlement proceeds, and lien rules vary by state. We record the attorney, case number and agreement, send itemized bills on request and track the balance. Please consult your attorney about how these documents work in your state; we do not give legal advice.
How do you bill workers’ compensation claims?
Work injuries go to the employer’s carrier, not the patient’s health plan. We collect the claim number, date of injury, employer and adjuster details, confirm the claim is accepted and any needed authorization is in place, and bill under the state fee schedule. Many states accept the CMS-1500, while others require their own forms or reports, so we follow the rules of the state where the claim is filed.
What documentation do attorneys and carriers ask for?
They usually ask for the accident date and mechanism of injury, findings tied to the accident, the treatment plan with progress notes, and itemized bills by date of service with payments and adjustments. Records requests need a valid HIPAA authorization or another legal basis before release. Our HIPAA-trained staff log each request, confirm the authorization and send only what is needed.
How does Medicare affect accident cases?
Under the Medicare Secondary Payer rules, auto, no-fault, liability and workers’ compensation coverage generally pays before Medicare for accident-related care. If that payer will not pay promptly, Medicare may make a conditional payment that must be repaid from any settlement. Providers then have to choose how to proceed, so we screen Medicare patients for accident or work injury at intake and confirm the route before billing.
What are the filing deadlines and common denials for no-fault claims?
States set their own deadlines, and some no-fault programs give providers only weeks from the date of service; New York, for example, uses 45 days. Common denials include late filing, the wrong payer, missing claim or accident data, medical necessity disputes, fee schedule reductions and exhausted benefits. We track a bill-by date for every service and check each claim before it goes out.
What does personal injury billing cost with BilNow?
BilNow charges 2.7% of collections. There is no setup fee and no long-term contract, so the fee follows the money your practice collects. Our HIPAA-trained staff work inside your existing practice management or EHR system, and we support more than 100 EHRs. No one can promise a recovery amount on a case, but we can review your current accident billing and show where balances are stuck.
Prepared by the BilNow Editorial Team · Last updated October 2, 2026
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