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Wednesday, December 11, 2013

Florida PIP EMERGENCY MEDICAL CONDITION (EMC) Form

EMERGENCY MEDICAL CONDITION (EMC)



For those physicians providing care to Florida patients involved in automobile accidents, this is important information:

THERE IS NO SPECIAL EMC FORM.

1.  The new law states that if the MD, DO, PA, Nurse, or dentist does not notate the patient file that the injured patient has an "emergency medical condition", the patient is limited to only $2500 of the full $10k in PIP insurance that the patient paid for.  

2.  This means that if in the future, the patient requires further medical care including diagnostic imaging, or surgical procedures, the patient will likely be cut off at $2500 from medical care.

3.  There is no rule that says that the EMC must be completed within 14 days.  Only that the first visit to a doctor must be within 14 days.  So, as long as the patient was initially seen within 14 days of his accident, he is covered under his FL PIP coverage.  

4.  If you see the patient and the patient comes in (up to 5 years) post accident beginning Jan 1, 2013, you should still designate the EMC (if the patient's condition warrants it)  in the patient file or you will most likely NOT get your bill paid.

5.  There is no special form for the EMC.  Just document it in the patient's file.  Just write, "medical emergency"  if the patient's condition warrants it.  It is recommended that you state that your decision to write that the patient has an EMC agrees with  one or more of these below:

(a) Serious Jeopardy to the patient health.
(b) Serious impairment to bodily functions.
(c) Serious dysfunction of any bodily organ or part.

6.  I am not a lawyer, so my disclaimer to you is that you should contact a PIP litigation lawyer in the state of Florida regarding any legal matter including this one.