House Bill 1471
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Florida House of Representatives - 2000 HB 1471
By Representative C. Green
1 A bill to be entitled
2 An act relating to personal injury protection
3 insurance claims; amending s. 627.736, F.S.;
4 increasing the allowable time for a provider to
5 file a claim with an insurer; deleting an
6 exception authorizing inclusion of certain
7 charges in a billing statement; requiring a
8 statement of charges within a time certain
9 under certain circumstances; limiting insurer
10 liability for payment of certain charges under
11 certain circumstances; providing requirements;
12 revising a billing statement notice
13 requirement; providing an effective date.
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15 Be It Enacted by the Legislature of the State of Florida:
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17 Section 1. Paragraph (b) of subsection (5) of section
18 627.736, Florida Statutes, is amended to read:
19 627.736 Required personal injury protection benefits;
20 exclusions; priority.--
21 (5) CHARGES FOR TREATMENT OF INJURED PERSONS.--
22 (b) With respect to any treatment or service, other
23 than medical services billed by a hospital for services
24 rendered at a hospital-owned facility, the statement of
25 charges must be furnished to the insurer by the provider and
26 may not include, and the insurer is not required to pay,
27 charges for treatment or services rendered more than 60 30
28 days before the postmark date of the statement, except for
29 past due amounts previously billed on a timely basis under
30 this paragraph, and except that, if the provider submits to
31 the insurer a notice of initiation of treatment within 21 days
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Florida House of Representatives - 2000 HB 1471
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1 after its first examination or treatment of the claimant, the
2 statement may include charges for treatment or services
3 rendered up to, but not more than, 60 days before the postmark
4 date of the statement. The injured party is not liable for,
5 and the provider shall not bill the injured party for, charges
6 that are unpaid because of the provider's failure to comply
7 with this paragraph. However, if the insured fails to furnish
8 the provider with the correct name and address of the
9 insured's personal injury protection insurer, the provider has
10 35 days from the date the provider obtains the correct
11 information to furnish the insurer with a statement of
12 charges. The insurer is not required to pay such charges
13 unless the provider includes with the statement documentary
14 evidence that was provided by the insured during the 35-day
15 period demonstrating that the provider reasonably relied on
16 erroneous information from the insured and a denial letter
17 from the incorrect insurer or proof of mailing reflecting
18 timely mailing to the correct address or insurer and provides
19 a copy of the statement of charges to the Department of
20 Insurance. Any agreement requiring the injured person or
21 insured to pay for such charges is unenforceable. For
22 emergency services and care as defined in s. 395.002 rendered
23 in a hospital emergency department or for transport and
24 treatment rendered by an ambulance provider licensed pursuant
25 to part III of chapter 401, the provider is not required to
26 furnish the statement of charges within the time periods
27 established by this paragraph; and the insurer shall not be
28 considered to have been furnished with notice of the amount of
29 covered loss for purposes of paragraph (4)(b) until it
30 receives a statement complying with paragraph (5)(d), or copy
31 thereof, which specifically identifies the place of service to
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Florida House of Representatives - 2000 HB 1471
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1 be a hospital emergency department or an ambulance in
2 accordance with billing standards recognized by the Health
3 Care Finance Administration. Each notice of insured's rights
4 under s. 627.7401 must include the following statement in type
5 no smaller than 12 points:
6 BILLING REQUIREMENTS.--Florida Statutes provide
7 that with respect to any treatment or services,
8 other than certain hospital and emergency
9 services, the statement of charges furnished to
10 the insurer by the provider may not include,
11 and the insurer and the injured party are not
12 required to pay, charges for treatment or
13 services rendered more than 60 30 days before
14 the postmark date of the statement, except for
15 past due amounts previously billed on a timely
16 basis, and except that, if the provider submits
17 to the insurer a notice of initiation of
18 treatment within 21 days after its first
19 examination or treatment of the claimant, the
20 statement may include charges for treatment or
21 services rendered up to, but not more than, 60
22 days before the postmark date of the statement.
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24 Section 2. This act shall take effect October 1, 2000.
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Florida House of Representatives - 2000 HB 1471
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2 HOUSE SUMMARY
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Increases from 30 to 60 days the allowable time a
4 provider has to submit an insurance claim to an insurer.
Deletes an authorization to include charges for
5 examination or treatment in a billing statement after
timely notice to the insurer. Provides a provider with 35
6 days in which to furnish an insurer with a statement of
charges if an insured fails to provide the provider with
7 correct insurer information. Limits the insurer's
liability to pay such charges if the provider fails to
8 furnish the insurer with specified information and
provide the Department of Insurance with a copy of the
9 statement of charges.
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