Everything You Need to Know About Injury Billing, Insurance, and Payment at ProCare

For any auto insurance coverage afforded, it is important that the injured party(ies) file or open a claim first. This can be against their own auto insurance accident injury coverage or the liable party’s auto insurance liability coverage.

Once a claim has been open or filed, the injured parties are given a claim #, adjustor name/contact info assigned, and other billing instructions. Patients would then bring this info with them at their first visit with ProCare.

📂 Documentation tip: Bring your claim number and adjuster details to your first appointment to avoid delays in billing.

Personal Injury Protection – aka, “optional coverage on the patient’s auto insurance policy”.
PIP pays for medical bills, lost wages (up to 80%), and other expenses for you and your passengers after a car accident, regardless of who was at fault.

💡 Good to know: PIP is often the fastest way to start treatment after a car accident.

It depends, but PIP coverage is specifically for car accident injuries.

Personal medical (or health) insurance coverage can assist, especially if PIP is not available, or for other issues subsequent to an auto accident, but it will only cover those insured on your insurance plan, not necessarily unrelated passengers in your car.

Yes. Health insurance plans may be mandated by networked provider select, pre-authorization or referrals, as well as deductibles or copays at time of service. It will only cover those insured in your household.

PIP or car insurance coverage usually does not have deductibles or out-of-pocket expense up front, has no network issues (for ProCare) and is ready to immediately use for you and each passenger in your vehicle once a claim has been opened.

For PIP or auto insurance policies, there is usually one lump sum to cover all medically necessary treatment related to that injury.

It may, depending on medical necessity and the facility restrictions. Some Imaging facilities do not accept PIP or Third Party insurance, but may accept health insurance instead.

ProCare takes x-rays in house, and those are usually covered when billed to PIP or Third party auto insurance coverage.

💡 Good to know: In-house imaging can reduce delays and out-of-pocket costs.

Depending on the health coverage plan, this will only take effect if no other carrier can cover this type of injury – ie patient or other party’s auto insurance. This may involve a written form or notice from the patient/insured to their insurance carrier, confirming no other coverage can be afforded for this injury.

Unfortunately, you must see an in-network provider for the majority of health insurance plans. Many of our specialists are not in network with health insurance plans due to these restrictions, so ProCare would not be able to submit claims to a health insurance payer on the patient’s behalf.

The patient can, however, submit their own bills to their carrier to see if they can be reimbursed for treatment received and paid out-of-pocket.

You still have options. You can pay our Self-Pay rates at time of service for each treatment visit.

However, due to the financial burden some may experience due to a car accident, you may choose to obtain legal representation to help divert out-of-pocket costs until settlement against the liable party is reached.

Our in-house billing department will dispute any insurance claims received. Most are resolved after the first dispute.

Yes! Our in-house Billing Department has over 15 years experience with multiple types of insurance carriers and billing, including dispute resolution and payment negotiation.

💡 Good to know: Direct billing minimizes paperwork and stress for patients.

No! We encourage you to come in and see what we have to offer you as your patient experience, as well as discuss payment options for those that do not have insurance.

Common car accident injuries to see an auto accident doctor for include:

• Head and neck injuries(whiplash, concussions, traumatic brain injuries)
• Back and spinal injuries (herniated discs, nerve damage, spinal column injuries)
• Soft tissue injuries (muscle strains, ligament or tendon tears)
• Broken bones and fractures (ribs, arms, legs, wrists, ankles, facial bones)
• Knee and joint injuries (often from dashboard or impact trauma)
• Internal injuries (internal bleeding or organ damage)
• Cuts, bruises, and swelling that persist or worsen
• Ongoing symptoms such as headaches, dizziness, numbness, stiffness, or limited mobility

⭐ Important for your health: Some injuries don’t show symptoms immediately, making early evaluation extremely important.

We strongly encourage you to see a doctor as soon as possible, ideally within 24 to 72 hours after a car accident. Early evaluation helps identify hidden injuries and provides critical medical documentation.

⭐ Important for insurance claims: Delays beyond 72 hours may impact claim approval or compensation.

Bring a valid photo ID and insurance card (if applicable) to your first appointment. We also recommend completing our new patient paperwork online before the appointment and arriving 10-15 minutes early so we can start your visit on time.