Florida’s HMO statute requires HMOs to pay healthcare providers directly for treatment billed by the provider for services rendered to the HMO’s member. Florida, however, cannot issue such an edict or requirement for out of state plans or PPOs. As a result, one of the most common complaints that we hear from providers is that payments for their services were sent to the patient and the patient never turned over that payment to the provider. Our position is that this is theft, plain and simple.
These payments are for treatment rendered by your physicians and staff, thus any attempt to keep these amounts is stealing from your practice. When you are made aware of this issue, time is of the utmost importance. The patient must be made aware that they are in violation of Florida’s Civil Theft Statute (§ 772.11), which may make them liable for three times damages and any attorneys’ fees or costs incurred in pursuing collection of these amounts.
Our office, when referred such cases, immediately sends a civil theft demand letter to the patient, guarantor or insured member, via certified mail. We attempt to make contact with the responsible party any way that we can which complies with the Fair Debt Collection Practices Act (FDCPA). If these methods prove unsuccessful, we can and do file suit on our clients’ behalf to recover the amounts sent to these patients by their healthcare insurance companies.
Don’t leave money on the table by failing to pursue these theft actions. Call us today to ask how we can help.