Are you a medical provider or a doctor? Have you rendered services to a patient but now you’re having trouble receiving payment? Through the PIP arbitration process of the National Arbitration Forum, (and possibly under New Jersey’s no-fault auto insurance laws) a qualified attorney can be of great assistance.
In hundreds of cases, a PIP arbitration lawyer has successfully been able to help medical providers get payment for outstanding/overdue bills for medical services.
Medical Treatments – Pre-Certification
Healthcare providers, doctors, and/or patients (for automobile accident injuries) may need certain types of medical treatment pre-certified. An insurance company may deny payment if pre-certification is needed but has not been received prior to treatment. In this case, an appeal could be filed.
As examples:
- For back and neck injuries, the medical need for physical therapy and chiropractic treatment may be contested by an insurance company. This happens more frequently than most people would like to believe.
- Also frequently contested by some insurance companies are the need for NCV/EMG studies, MRIs, and other diagnostic tests.
These areas of the law can be complicated and hard to navigate. Medical professionals should acquire competent, experienced legal representation in cases such as those described above, and others.
The National Forum for Arbitration – Forthright
With the NAF (National Arbitration Forum)/Forthright, medical providers, doctors, and patients (injured in automobile accidents) can file an Arbitration Demand if they have been denied payments by an insurance company, for services rendered. Make no mistake, however, this is not a lawsuit. To resolve the dispute between an insurance company and the provider, it is simply a request being formally made to the NAF/Forthright for the appointment of an arbitrator.
Licensed attorneys, these arbitrators are experienced in dispute resolution and PIP arbitrations. For both sides involved in a dispute, arbitrator decisions are binding. Clearly, representation by an experienced, knowledgeable, qualified PIP arbitration attorney is recommended for patients, doctors, medical providers, etc.
Medical Professionals Seeking Payment
There are couple of types of arbitration proceedings:
- On-the-papers: Documentation is submitted by representatives or the parties themselves and, solely based on the documentation, the DRP (Dispute Resolution Professionals) decides the case.
- In-person: Representatives of parties or the parties themselves appear telephonically or in-person to present their case before the DRP.
If you are seeking payment for services rendered as a medical professional, the following are the steps that should be taken to start the arbitration process:
- Get in touch with a qualified legal representative who is not only knowledgeable about but experienced in PIP arbitration. A demand for arbitration can be filed. Your attorney will be aware of the information required in such a demand, provided they are experienced and knowledgeable in PIP arbitration.
- The NAF/Forthright will appoint an arbitrator through which you will be able to begin the dispute process.
- Forthright Solutions (NAF) sets forth the rules and regulations by which to decide cases such as this. To make their decision, the arbitrator will hear arguments representing the case from both sides.
In the case of denial, appeals may be filed.
Are You Seeking Payment for Medical Services You Provided?
If you are a medical professional who has cared for a patient, but your payment has been denied by the insurance company, don’t hesitate to hire a PIP arbitration lawyer from Corradino and Papa, LLC. Contact us today for a free consultation.
Disclaimer: Results may vary depending on your particular facts and legal circumstances.