For anyone treating patients involved in motor vehicle accidents, it’s vital to be aware of the 45-day rule.
This rule applies to no-fault insurance claims, which aim to provide coverage for medical expenses that
arise from an accident.
Under the 45-day rule, medical providers only have 45 days from the date of service to submit a claim to
the no-fault insurance carrier. Failure to submit the claim within this time frame could result in the claim
being denied. Once denied, this leaves the provider without payment for any services rendered. Without
satisfactory explanation for a late claim, this denial can be permanent.
To ensure timely submission of claims, providers should set established procedures to keep track of
dates of service as well as any claims already submitted. In addition, including information such as the
date of service, the diagnosis, and treatment provided is crucial. Alternatively, working with a billing
specialist or a third-party billing service may be beneficial.
While the 45-day rule may seem like an additional burden, it ensures medical providers receive fair
compensation for services rendered. By understanding and complying with this rule, providers can help
ensure that their patients receive the care they need without financial hardship, as well as ensure
prompt payment for their services.
Over One Billion in Verdicts, Settlements and Awards for Our Clients
Plaintiff sustained a series of fractures and other injuries to the right shin, heel and foot, requiring nailing of the right tibia with two proximal and two distal locking bolts, ultimately resulting in below-the-knee amputation
Infant plaintiff sustained encephalopathy as result of DPT vaccination administered by NYC Health and Hospitals Corporation.
Plaintiff was involved in a car accident resulting in multiple disc herniations requiring percutaneous fluoroscopic-guided epidural treatment and lumbar fusion laminectomy.
47 year old male police officer injured as a result of surgical malpractice by an orthopedic surgeon resulting in an inability to work and permanent impairment of gait.
Wrongful death case settled at the Appellate level, 44-year-old husband and father drowned while swimming in a municipal pool.
69 year old female with underlying osteoporosis and preexisting spinal degeneration awarded as a result of a motor vehicle accident causing an acute T12 fracture of her spine.
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