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Important Update: Coordination of Benefits for Auto Accident Claims
Florida Blue·FL·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 16, 2026
Summary
Florida Blue updated coordination of benefits guidelines for auto accident claims, requiring providers to document accident information, submit claims to auto insurance first as primary payer, then submit to Florida Blue as secondary with required documentation including EOBs and exhaustion letters.
Action Required
Immediately: Billing team must update workflows to ask all patients if services are related to auto accidents and document the accident date. Submit all auto accident claims to auto insurance carriers first as primary payer. After primary processing, submit claims to Florida Blue with attached auto carrier EOB or exhaustion letter, no PIP coverage statement (if applicable), and PIP worksheet (if available). Update CMS-1500 forms to accurately complete Box 10B, Field 14, and Section 21. Update UB-04 forms to accurately complete Fields 33-35, 18-28, 39-41, 67-74, and 72. Do not balance bill members - collect coinsurance only after both insurance payments received. Payment will be based on lesser of Florida Blue allowance or auto carrier payment.