No-Fault

Eight Unit Rule Applies to Each Individual Provider Per Day

A nice win for New York No-Fault Chiropractors, Physical Therapists and Massage Therapists.  The “eight unit rule” under the Worker’s Compensation Fee Schedule applies to each individual practitioner for each day, not the total of all modalities on a given day.

This is a case of first impression, meaning, no other court decisions before this one has addressed this issue. We will need to watch and see if this case is appealed and, if so, what the ultimate outcome will be, but for now, each individual provider will get to bill a total of eight units per day.

Examinations Under Oath and Insurance Company Silliness

I recently represented a Licensed Massage Therapist at an Examination Under Oath (or EUO, for what should be obvious reasons).  Present at the unusually long conference table were the typical insurance carrier archetypes I know so well: the pleasant questioning attorney for the insurance company, the stone-faced and silent SIU representative, the court reporter with her mysterious mini-typewriter and stacks of exhibit tabs and four freshly-minted insurance lawyers who were being trained in “Insurance Fraud 101.”

Do you add “Signature on File” to your No-Fault Bills?

If you do not sign each of the bills you submit to the No Fault carrier, it has the right to delay the bill and demand a bill be submitted with your original signature.  According to a 2006 lower court decision, the insurance company is not obligated to accept a copy of an Assignment of Benefits nor electronic signature or the words “Signature on File” on your HICFA form.

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