Behind the scenes
How a Texas PIP Claim Actually Works.
Behind the scenes, a PIP claim has predictable steps. Knowing them helps you spot when something's stuck — and it shouldn't be.
- 1
Report the accident to your auto insurer
You (or your attorney) report the accident and request a PIP claim be opened. The insurer assigns a claim number — that's the number our office uses for every subsequent submission.
- 2
Provider verification
Our billing team contacts your insurer to confirm coverage was in force, the remaining benefit amount, and the insurer's specific submission requirements. Usually one phone call.
- 3
Submission of treatment claims
For every visit, we submit a claim with diagnosis codes, treatment codes, and documentation of medical necessity — structured to align with what Texas PIP carriers require.
- 4
Payment from insurer
Insurers typically process valid PIP claims within 30–60 days. Payment goes directly to our office. You don't write a check.
- 5
When PIP is exhausted
If you're approaching your PIP limit, we communicate with you in advance. Options include health insurance, letter-of-protection care, or self-pay — we walk you through the choices.
Common issues we manage on your behalf
- Denials for “not medically necessary” — addressed by additional documentation
- Coding disputes — corrected and resubmitted
- Slow payment — followed up by our billing team, not by you
- Complex coordination with health insurance — handled in our office
Questions about your specific claim?
Talk to our billing team — we'll walk you through what to expect for your situation.