11 Fla. L. Weekly Supp. 274a
Insurance — Personal injury protection — Coverage — Conditions precedent — Notice of loss — HCFA form — Because statute requires that all statements and bills for medical services be submitted to insurer on HCFA form, insured’s submission of itemized statement of charges not on HCFA form did not provide notice of medical charges — No merit to argument that submission of itemized statement tolled time for payment of bills until subsequent submission of HCFA form — Legislative history and case law do not support exception to HCFA requirement for statements in substantial compliance with statutory requirements — Summary judgment in favor of insurer affirmed
SHARON BRYANT, INDIVIDUALLY AND AS PARENT AND NATURAL GUARDIAN OF LAWRENCE STOKES, A MINOR, Appellant, vs. DIRECT GENERAL INSURANCE COMPANY, Appellee. Circuit Court, 7th Judicial Circuit (Appellate) in and for Volusia County. Case No. 2003-00010-CAAP. L.C. Case No. 2001-12033-CODL. January 9, 2004. Counsel: Kimberly P. Simoes, for Appellant. Louis D. Kaye, Allen, Kopet & Associates, PLLC, Orlando, for Appellee.OPINION OF THE COURT
(GRAHAM, RICHARD S., Judge.) Appellant, Sharon Bryant, individually and as parent and natural guardian of Lawrence Stokes, a minor, appeals the County Court’s November 1, 2002 [10 Fla. L. Weekly Supp. 44a], order denying plaintiff’s motion for summary judgment, and April 29, 2003, order granting defendant’s motion for final summary judgment. We affirm.
I. FACTUAL AND PROCEDURAL BACKGROUND
This action originated from a dispute concerning entitlement to personal injury protection coverage through a policy of insurance issued to Appellant, Sharon Bryant, the natural parent of Lawrence Stokes. As a result of a motor vehicle accident on August 8, 2000, Lawrence Stokes sought care from Brooks Rehabilitation Center, hereinafter Brooks, on January 12, 2001, January 17, 2001, January 19, 2001, January 23, 2001, February 12, 2001, and February 16, 2001. Appellee, Direct General Insurance Company, had stipulated that treatment for the foregoing dates of service were reasonable, necessary, and related to the August 8, 2000, accident. On February 19, 2001, Appellant submitted an itemized statement of charges to Appellee for treatment rendered by Brooks. This itemized statement identified the name of the injured person, name of the health care provider, dates of service, a description of the procedure performed, and an itemization of the charge for each procedure. This itemized statement was received by Appellee on February 22, 2001.
On March 21, 2001, Appellee corresponded with Brooks to request that the bills be submitted on a Health Care Finance Administration 1500 form, hereinafter HCFA.1 Appellee concedes that the bills were submitted by Appellant, not Brooks, and that Brooks had not accepted an assignment of benefits. On May 2, 2001, Appellee received the resubmitted bills from Brooks on the HCFA. These forms were mailed to Appellee from Appellant’s counsel. The dates of service received by Appellee were January 12, 2001, January 17, 2001, January 19, 2001, January 23 , 2001, February 12, 2001, and February 16, 2001. The total bill for these dates of service was $1,135.00. On June 12, 2001, Appellee mailed its explanation of benefits to Brooks advising that the bills submitted were untimely and payment would not be forthcoming. On the same date, Appellee requested that Brooks send proof of mailing as Appellee denied having prior notice of the bills.
Based on this denial, Appellant filed a complaint in the Volusia County Court on August 28, 2001, seeking payment of medical bills incurred by Lawrence Stokes. Appellant filed a motion for summary judgment on February 5, 2002. Following argument of counsel, the motion was denied by County Court Judge J. Roger Smith on November 1, 2002. The Court determined that to satisfy the provisions of Section 627.736(5)(b), Florida Statutes (2000), a statement of charges must comply with the statutory requirements found in Section 627.736(5)(d), Florida Statutes (2000)2, and be submitted in the required format within the thirty day time frame found in Section 627.736(5)(b).3 Thereafter, Appellee filed its motion for final summary judgment on February 14, 2003, which was granted on April 29, 2003, by County Court Judge Thomas E. Bevis based upon the Court’s earlier November 1, 2002, order. Appellant filed the notice of appeal on May 28, 2003, seeking appellate review of the County Court’s November 1, 2002, order and April 29, 2003, order. The nature of the orders is the final summary judgment granted to Appellee. After being granted an extension of time, Appellant filed her initial brief on August 25, 2003. After being granted an extension of time, Appellee filed its answer brief on October 1, 2003. After being granted an extension of time, Appellant filed her reply brief on November 4, 2003.
II. CONCLUSIONS OF LAW
This Court affirms final summary judgment for Appellee. Where no genuine issue as to any material fact is shown to exist, the only question for the appellate court is whether the summary judgment was properly granted under the law, and generally, unless the trial court has abused its discretion, its determination will not be interfered with on appeal. Wesley Const. Co. v. Lane, 323 So. 2d 649 (Fla. 3d DCA 1975); Ocean Villa Apartments, Inc. v. City of Ft. Lauderdale, 70 So. 2d 901 (Fla. 1954). The sole issue on this appeal is whether the trial court erred in reading Section 627.736(5)(b), Florida Statutes (2000) in pari materia with Section 627.736(5)(d), Florida Statutes (2000) to make the legal conclusion that a patient/insured must submit a statement of charges, on a HCFA 1500 form or other approved form, to the insurer for medical treatment or services rendered by any physician, hospital, clinic, or other person or institution within 30 days of the postmark date of the statement. This Court finds the trial court’s reading of the statute to be consistent with statutory interpretation and legislative intent.
The construction of statutes, ordinances, contracts, or other written instruments is a question of law that is reviewable de novo by the appellate court, unless their meaning is ambiguous. See Dixon v. City of Jacksonville, 774 So. 2d 763 (Fla. 1st DCA 2000). The law clearly requires that the legislative intent be determined primarily from the language of the statute because a statute is to be taken, construed, and applied in the form enacted. Thayer v. State, 335 So. 2d 815, 817 (Fla. 1976). The reason for this rule is that the Legislature must be assumed to know the meaning of the words and to have expressed its intent by the use of the words found in the statute. Id. It is a basic rule of statutory construction that all parts of a statute must be read together in order to achieve a consistent whole. See Akel v. Dorcelus, 793 So. 2d 1049 (Fla. 4th DCA 2001). Where possible, courts must give effect to all statutory provisions and construe related statutory provisions in harmony with one another. See Forsythe v. Longboat Key Beach Erosion Control Dist., 604 So.2d 452, 455 (Fla. 1992).
Section 627.736(5)(b), Florida Statutes (2000) requires that the statement of charges furnished to the insurer may not include charges for treatments rendered more than thirty (30) days before the postmarked date of the statement, subject to certain exceptions not applicable to this case. Section 627.736(5)(d), Florida Statutes (2000) requires that “all statements and bills for medical services rendered by any physician, hospital, clinic, or other person or institution shall be submitted to the insurer on a Health Care Finance Administration 1500 form. . .or. . .any other standard form approved by the department for purposes of this paragraph….. All billings for such services shall, to the extent applicable, follow the Physicians’ Current Procedural Terminology (CPT) in the year in which services are rendered.” Section 627.736(5)(d) further provides “. . .For purposes of paragraph (4)(b), an insurer shall not be considered to have been furnished with notice of the amount of covered loss or medical bills due unless the statements or bills comply with this paragraph.” Section 627.736(4)(b), Florida Statutes (2000) states “Personal injury protection insurance benefits paid pursuant to this section shall be overdue if not paid within 30 days after the insurer is furnished written notice of the fact of a covered loss and of the amount of same.” It appears that the Legislature desired to apply the HCFA form requirements of Section 627.736(5)(d) to both all of Section 627.736(5), entitled “Charges for treatment of injured persons. — ”, and the notice provision of Section 627.736(4)(b).
The Legislature history of Section 627.736 support the logical and unambiguous interpretation reached by the trial court. On page 97 of the exhibit attached to Appellant’s initial brief is a discussion of the Florida Senate’s analysis of the effect of amending Section 627.736 to include the HCFA form requirement to all medical statements and charges.4 The Senate staff analysis discusses the effect of the proposed amendment: “These provisions attempt to standardize billing statements and would have the effect of reducing any ambiguity as to which medical treatments were provided. These provisions would make it easier for insurers to understand precisely what medical services they are compensating.” The Florida House of Representatives Committee on Financial Services Final Bill Research & Economic Impact Statement dated May 28, 1998, states within page 73 of the appendix attached to Appellant’s initial brief that is entitled “Billing requirements”: “The bill would also standardize billing by requiring that all bills for medical services be submitted to the insurer on a standard form and follow the Physicians’ Current Procedural Terminology.” Therefore, the legislative intent of enacting Section 627.736(5)(d) was to standardize medical billing statements, and make it easier for insurers to understand precisely the medical services they were compensating.5 Before the enactment of requiring standardized forms in 1998, medical bills were submitted in a myriad of forms making it difficult for insurers to review the bills and identify what services were performed. It is commonsensical to understand that requiring these bills to be submitted on standardized forms would assist in prompt payment of medical bills. Sections 627.736(5)(b) and 627.736(5)(d) must be read together to be consistent and in harmony with legislative intent.
Appellant argues that a statement of charges not on a HCFA form could be made within thirty (30) days and that would comply with Section 627.736(5)(b), and that the time under the statute to pay the bill is tolled until the subsequent submission of the HCFA form in compliance with the CPT Code provisions. Appellant’s interpretation of Section 627.736(5)(b) in relation to Section 627.736(5)(d) would result in causing insurance companies to hold and reserve benefits for an uncertain time in which they would continue to be liable for payment of any medical bills no matter when they were submitted on HCFA forms. Appellant contends that the trial court’s interpretation that requires submission of a HCFA form would have an absurd result. As revealed from the record of the proceedings below, the itemized statement submitted by Appellant on February 19, 2001, was not on a HCFA form as required by Section 627.736(5)(d), nor did the statement include the CPT coding which enables an insurer to promptly determine what services were provided. Though Appellant attempts to claim that the itemized statement was in substantial compliance with the requirements of Sections 627.736(5)(b) and 627.736(5)(d), the legislative history of Section 627.736 and case law to not support such an exception. The record of the proceedings below reveal that Appellant withdrew her arguments regarding the issue of estoppel, and Appellee’s alleged failure to comply with Sections 627.7401, Florida Statutes (2000) and 627.736(5)(b). Appellate court should review only those alleged errors properly presented to it, and only those issues presented to and ruled on by the lower tribunal. Clark v. Department of Professional Regulation, Bd. of Medical Examiners, 463 So.2d 328 (Fla. 5th DCA 1985). This Court finds Appellant’s other arguments contained in her initial brief and reply brief to be without merit and not persuasive. Therefore, the trial court’s entry of final summary judgment was properly granted under the law in which the record of the proceedings below reveals no abuse of discretion.
Accordingly, and for the reasons set forth above, County Court’s Order Granting Defendant’s Motion for Final Summary Judgment dated April 29, 2003, is hereby AFFIRMED.
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1A copy of Appellee’s March 21, 2001, correspondence was not mailed to Appellant or Appellant’s counsel, and at no time did Appellee request the additional information from Appellant.
2The Court notes that Appellant relies on the pre-2001 version of portions of Section 627.736, Florida Statutes, whereas the county court and Appellee allude to the post-2001 version. Section 627.736 has been amended by the Florida Legislature several times since 2001, however, this is irrelevant to this Court’s appellate review of the proceedings below.
3The Court’s November 1, 2002, order denying Plaintiff’s motion for summary judgment specifically provides: “. . . .2. Nevertheless, the language of the statute is clear and there is no glaring ambiguity in the statute. Fla. Stat. 627.736(5)(e) clearly states: “All statements and bills for medical services . . . .shall be submitted” on a HCFA form. The Plaintiff’s itemized statement for medical treatment and letter sent to the Defendant/Insurer on February 19, 2001 was not a part of, nor attached to, a HCFA Form. Plaintiff’s itemized statement and letter did not meet Fla. Stat. 627.736(5)(e) requirements. Submission of Plaintiff’s medical treatment on a HCFA 500 form (sic) during the thirty-day period following the date of treatment is a clear requirement of the statute. . .”
4The analysis of enacting future Section 627.736(5)(d) is contained within a document entitled “Senate Staff Analysis and Economic Impact Statement” dated March 31, 1998.
5Section 627.736(5)(b) dealing with the statement of charges furnished to an insurer which must include charges within a 30 day time limit, and Section 627.736(5)(d) dealing with the standardization of medical statements and bills were enacted in 1998.
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