Florida PIP Deadlines: What Providers Must Know About the 30-Day and 75-Day Rules
Florida’s Personal Injury Protection (PIP) system includes very specific billing timelines that medical providers must follow to ensure their claims are payable. While most providers are familiar with the 30-day period insurers have to respond to a properly submitted claim, fewer understand the provider side of the timeline—especially the option to extend the billing deadline to 75 days by submitting a Notice of Initiation of Treatment (“NIT”).
This article provides a simple breakdown of:
- The 30-day insurer payment rule
- The provider billing deadlines
- How the 21-day NIT window works
- When the 75-day extension applies
- Why submitting the NIT helps protect your clinic
1. The Insurer’s 30-Day Rule
Under Florida Statute § 627.736(4)(b):
Once a clean claim is submitted, the insurer has 30 days to:
- Pay the claim
- Pay a reduced amount
- Deny the charge
- Request additional information
- Investigate for fraud or misrepresentation
- Issue an IME or EUO request
This 30-day rule is the insurer’s timeline, not the provider’s.
However, the provider must submit the bill properly to trigger that 30-day response requirement.
2. The Provider’s Billing Deadline: 35 Days
Under Florida PIP rules, medical providers must submit their bills within 35 days of the date of service, unless they qualify for the extended 75-day timeframe.
This 35-day deadline is strict for providers who do not submit an NIT.
✔ Bill submitted within 35 days → Claim is valid
✘ Bill submitted after 35 days → Insurer may deny as “untimely”
Because many clinics batch-bill or run behind after busy weeks, this deadline catches providers off-guard.
3. How Providers Can Extend the Deadline to 75 Days
Florida law allows medical providers to extend their billing window from 35 days to 75 days, BUT ONLY if the provider sends a Notice of Initiation of Treatment (NIT) within 21 days of the patient’s very first treatment date.
This is the most important timing rule for provider billing.
4. Understanding the Notice of Initiation of Treatment (NIT)
The NIT is a simple notice sent to the insurer stating that:
- You began treating the patient
- On a specific date
- For injuries related to the motor vehicle accident
The statute does not require detailed records—just timely notice.
5. The 21-Day Rule for Sending the NIT
To qualify for the 75-day extended billing window:
✔ The NIT must be sent within 21 days of the patient’s first date of treatment.
This applies only to the initial treatment—not every subsequent visit.
Examples:
- First visit: May 1
- NIT deadline: May 22
- Billing window: 75 days from date of service
If a clinic sends the NIT late—even by one day—the 75-day extension is not available.
6. How the 75-Day Billing Window Helps Clinics
The extended billing period gives providers more flexibility, especially those who:
- Bill monthly
- Submit claims in batches
- Experience coding or documentation delays
- Need more time to process complex treatment plans
- Are busy with high patient volume
With the NIT properly submitted:
✔ Bills may be submitted up to 75 days after the date of service
✔ Insurers must still follow the 30-day rule after receiving the claim
✔ Providers reduce the risk of denials due to “untimely submission”
This simple step can protect thousands of dollars in otherwise lost reimbursement.
7. Why Many Clinics Miss This Requirement
Common reasons providers miss the 21-day NIT deadline:
- Staff not trained on PIP timelines
- Billing teams unaware of the extended 75-day option
- Patients delaying paperwork
- Busy clinics batching bills weeks later
- Intake not confirming correct accident date
- Misunderstanding that the rule applies to the first treatment date, not later dates
Training intake staff on this timeline prevents most of these issues.
8. Practical Steps for Clinics
✔ A. Ask intake patients:
“When was the accident?”
This determines timing immediately.
✔ B. Log the first treatment date clearly
This date controls the 21-day NIT deadline.
✔ C. Submit the NIT the same day the patient first visits
Most clinics handle this electronically.
✔ D. Track NIT submissions in a simple spreadsheet or EHR note
✔ E. Educate billing staff on the difference between:
- 35-day billing rule
- 75-day extended billing rule
- 30-day insurer payment rule
This eliminates the majority of avoidable denials.
9. Key Takeaways
- Providers must normally bill PIP claims within 35 days.
- The deadline can be extended to 75 days if the NIT is submitted within 21 days of the first treatment.
- Insurers must respond to claims within 30 days once received.
- Missing the NIT deadline often results in unpaid or denied bills.
- Efficient intake and billing procedures ensure PIP compliance.
Conclusion
The 30-day insurer response rule, the 35-day billing deadline, and the 21-day NIT requirement all work together to shape the PIP reimbursement process. Clinics that understand and follow these timelines significantly reduce denials, improve payment reliability, and protect revenue.
