Free Consultation 24/7
516-712-2969
Current Clients Call 516-227-2662

BREAKING NEWS IN NO-FAULT! NEW AMENDMENTS RE FEE SCHEDULE AND VERIFICATIONS

There are new amendments to the No-Fault regulations, effective 4/1/13. They apply to all services provided after 4/1/13. In a nutshell, they are:

  1. A provider has 120 days to respond to verification requests asking for documents; NOT EXAMINATIONS. If not submitted within 120 days, then the insurer may deny for failure to supply the verification, regardless of whether the denial is timely or not. If a document is not within the custody or control of the provider, the provider must give written proof within 120 days (e.g. saying that they do not have the document, or it does not exist, etc.).
  2. The amount of the bill that is over the fee schedule is not considered to be received.
    1. Example: If a provider bills $76.03 bill for physical therapy in one day, then the insurer would only be liable for $67.60, regardless of whether the denial is timely or not.
  3. Claims for services or supplies that have not been provided are not considered to be received either. The insurer may deny regardless of whether the denial is timely or not.
  4. Technical defects in an NF-10 are excused.
    1. Example: Obvious typographical errors that would not prejudice either party if determined to be a technical defect.

No Comments

Leave a comment
Comment Information

Contact Us

Rubin & Licatesi, P.C.

How Can We Help You?

Bold labels are required.

Contact Information
disclaimer.

The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

close

Privacy Policy

Rubin & Licatesi, P.C.
591 Stewart Avenue 4th Floor
Garden City, NY 11530

Phone: 516-712-2969
Fax: 516-227-3374
Map & Directions

Brooklyn Office
3857 Kings Highway Suite 1F
Brooklyn, NY 11234

Phone: 516-712-2969
Phone: 718-712-6864
Map & Directions

Bronx Office
3585 East Tremont Avenue
Bronx, NY 10465

Phone: 718-710-4880
Map & Directions

Current Clients: 516-712-2969
map
map
map
Attorneys