If you are a medical provider and reading this webpage, do you know off the top of your head how much money you bill for an initial examination code? Do you know how much PIP pays you for that very code? If you know the answers to these questions then you would also know that a PIP insurance company likely underpaid the majority of your Evaluation & Management Services. NJ PIP issues become more complicated with limited policies, causation attacks, eligibility questions and improper medical necessity denials.
This is where our services come into play.
We can review your patient files for underpayments and help identify those files you were underpaid on then our trained staff will scan the necessary paperwork into our secured server. We will also help build an internal PIP No-Fault workflow or collaborate with your existing process to establish a consistent PIP cash flow. Judd Shaw has collected millions on behalf of clients and while insurance companies care about their bottom line, Judd and our PIP No-Fault team will fight for your growth and top priorities. Judd Shaw and the Shaw Kreizer New Jersey PIP No-Fault Arbitration Department has the acute understanding of our clients’ needs and we have the talent and experience to obtain huge results.
Judd Shaw has been industry focused for over ten years and has continued to redefine the way law is practiced with medical providers. Contact Judd Shaw and the Shaw Kreizer Trial & Injury Lawyers today and Experience Results.
Shaw Kreizer and Judd Shaw are top lawyers of choice for medical providers and clients seeking Personal Injury Protection (PIP) No-Fault insurance benefits. Named as one of New Jersey Super Lawyers Rising Stars, in both litigation and alternative dispute resolution, Judd is widely respected for his injury knowledge and experience. He understands medical providers and makes their priorities, the firm’s priorities.
What type of medical providers seek New Jersey No-Fault benefits?
Shaw Kreizer personally serves a wide variety of healthcare clients, including multi-disciplinary practices, physicians and physician groups, hospitals, ambulatory care facilities, diagnostic facilities, skilled or certified practitioners, billing managers and supply care companies. Due to our lawyers’ substantial experience in the New Jersey & New York No-Fault Arbitration process, Shaw Kreizer is often called upon to assist in navigating through the alternative dispute resolution process, including how to challenge or enforce arbitration awards. Our Team of Lawyers spends considerable time monitoring the industry’s ever-changing healthcare regulations, orders, bulletins and case law as well as changes in the advancing medical technology, particularly in the way spinal surgeries are performed and MRI testing guidelines. The firm’s experience includes the excessively regulated specialty areas that are of particular interest to the healthcare industry, including compliance, self-referral, anti-kickback, payment and reimbursement matters, licensure and certification and coverage issues.
While each provider is different in the type of speciality practiced and the way business is run, you should talk to an experienced New Jersey PIP No-Fault insurance lawyer from our firm, and find out how we can help increase your reimbursements. Call Shaw Kreizer Trial & Injury Lawyers toll free at 1-800-365-1234 or contact us via e-mail for a free consultation at either email@example.com or firstname.lastname@example.org.
Important NJ PIP Facts and Resources:
The current fee schedule was adopted in January 2013 –
A copy of the Physicians’ and ASC Fee Schedule as well as Dental, Home Care, Ambulance, Durable Medical Equipment, and Hospital Outpatient Surgical Facility charges may be found at http://www.state.nj.us/dobi/pipinfo/aicrapg.htm.
PIP No-fault arbitration recovery on disputed payments will cost you nothing! We do not charge an attorney fee or require reimbursement of costs and if we cannot collect on your behalf, you don’t pay anything. We also do not take any percentage or fee from our clients’ recoveries.
Forthright now allows claims under $1,000 to be filed without an oral hearing, which means faster end dates and quicker resolution.
Forthright, has been selected by the State of New Jersey to administer No-Fault Insurance Personal Injury Protection (PIP) arbitrations under the State’s Automobile Insurance Cost Reduction Act. Forthright began administering No-Fault PIP claims in New Jersey on April 1, 2011.
A copy of Forthright’s Amended Rules Effective April 15, 2013 can be found at http://www.nj-no-fault.com/main.aspx?itemID=225&hideBar=False&navID=222&news=24, along with Frequently Asked Questions and the overview of the NJ PIP arbitration process.
Shaw Kreizer provides free, complimentary on-site consultations and assistance.
Shaw Kreizer can assist in executing your internal appeals process, which is required by insurance companies through their Decision Point Review Plans, and Our Team will monitor your files for the earliest filing date. Our incentive is to get your matter into the pipeline as fast as possible and before the insurance benefits exhaust under the policies.
Our NJ No-Fault PIP claims lawyers will get you your fair share of the millions we expect to recovery in PIP this year.
How do our clients stay informed on PIP referrals?
Our office believes in maintaining open communications with clients. We are always available by phone or email for any questions. We are open early and stay late for the convenience of all our medical providers that may work at all times of the day. You can speak to a well-qualified PIP team member from 7 am to 7 pm. Shaw Kreizer also recognizes that you want to know what is going on with your files so we provide a client portal that allows live, accurate and current information on the status of your files. Our clients can “virtually look into” their files, 24/7. In addition, our clients will be notified electronically when their file moves to the next stage of the Forthright process.
We know security is important and our system delivers bank grade leading encryption to ensure your data is safe. Clients will be capable of managing all referrals, in real time and in one central location, available for viewing from any computer. With search technology, a dashboard reveals critical information we know is important to our clients. We find our client enjoy receiving our eStatus Update Notifications – there is no longer the need for our client to contact our office and request status or information on a certain matter.
Shaw Kreizer holds an exclusive subscription with a PIP No-Fault Arbitration Software system that teams the market leading strengths of technology to transform efficiency and client transparency through a new class of business/legal case management software. The relationship aims to redefine the way work will get done, address key industry challenges and spark true capabilities for the firm’s clients. The industry specific solutions developed exclusively from the ground up, seeks to include a client portal, provide real time status notifications, integrate internal management tools and offer secure service and support tailored to the needs of our clients. Until now, no other web based legal software was designed exclusively for PIP No-Fault arbitration practice.
The web based system can transform specific aspects of how medical providers and firm employees work, allowing new levels of efficiency, effectiveness and client satisfaction faster and easier than before. The Shaw Kreizer Trial & Injury Lawyers recognize how the phenomena of data and cloud is transforming business and our industry in historic ways. The system is secure cloud based software. Forthright operates electronically, allows Demands to be filed online, has recently launched a mobile version that can be used from any tablet or phone, and enhanced its online portal with new technology through SettlementIQ. The Shaw Krezier PIP No-Fault arbitration team aimed to bring the same kind of transformation to the way we work and perform, so that we can operate seamlessly with Forthright’s process, speed and smart settlement solutions. It’s all there for our clients to see, because our file is their file.
What is the process for New Jersey No-Fault PIP arbitration?
When a PIP insurance company either refuses to make payment or pays the bill incorrectly and the claim has been appealed, we will file a lawsuit against the PIP insurer to collect the money you may be owed.
You are known as the Claimant, who files a Demand for Arbitration with Forthright in accordance with Forthright’s NJ No-Fault PIP Arbitration Rules. The Demand could seeks benefits over $1,000.00, which would provide an oral hearing by the parties; alternatively, if the claim is less than $1,000.00, then the matter would proceed on-the-papers and without an in-person proceeding. There is ZERO out-of-pocket cost for our clients. We represent medical providers throughout the entire state of New Jersey and have collected millions of dollars from insurance companies. If we don’t collect money then there is no charge.
Forthright notifies all parties of the arbitration with an initiation letter and will assign a Dispute Resolution Professional (DRP) from its panel to decide the issue. Shaw Kreizer Trial & Injury Lawyers regularly appear Statewide and before all DRPs in the North, Central and Southern regions. For in-person proceedings, Forthright will set a date, time and location for the hearing. The Shaw Kreizer system will provide the information to you so that you know when to expect your date and the date of any arbitration award.
At the time of the hearing, the parties attend the in-person proceeding before the the DRP and present their evidence. The DRP considers the parties evidence and issues a written decision within 45 days from the closing date. Recall for on-the-papers proceeding, the parties will submit briefs and a DRP will render a decision without oral arguments.
The Shaw Kreizer Trial & Injury Lawyers Process follows Forthright’s Roadmap, but does so electronically, which provides for faster service to our client. Whether our client transfers matters by hard copy or email, your paperwork is scanned into our firm’s secure computer network so your office doesn’t have to be bothered with follow-up requests for paperwork. Having your file paperless allows for us to transmit and upload documents more efficiently and to store larges amounts of data.
No Recovery For You; No Recovery For Us
Our firm generates money by dealing with a high volume of PIP files and investigating each file to find out if money is owed. It’s possible to collect money on your old files. Our Team reviews every file we receive carefully to ensure that we have all necessary documents and that the appeals process has exhausted and then seek every dollar you are owed from insurance companies. Our detailed screening is required because if YOU don’t get paid on a claim then WE don’t get paid. If our office has to file a NJ PIP No-Fault Demand for Arbitration against an insurance company then New Jersey law requires the insurance company to pay for our attorney’s fees. We never charge medical providers for our attorney’s fees.
At Shaw Kreizer Trial & Injury Lawyers, a New Jersey PIP Law Firm, we believe in building long lasting relationships with our clients and look forward to helping you collect the money you may be owed from PIP insurance companies. Judd Shaw is relationship driven and every client matters. The PIP No-Fault practice is built one Demand at a time, and every case is treated with the same diligent representation no matter the amount of the claim.
What is Personal Injury Protection (PIP)?
For medical providers looking to provide treatment to NJ automobile accidents, PIP stands for Personal Injury Protection. It is also known as “no-fault” coverage. All New Jersey motor-vehicle owners are required to maintain PIP by law. For instance, New Jersey provides a basic policy of $250,000.00 in medical expenses regardless of fault.
How do I know if a patient is covered through PIP?
The patient should have an auto insurance card. Make a copy. If they reported the car collision then they should have been assigned a claim number from the PIP insurance company. If the patient has treated with other medical providers before presenting to your office, you should ask the PIP insurance company to provide a “PIP payment log” so that you can determine how much, if any, coverage is remaining. Remember that once the policy limits are reached then benefits have exhausted and, for the most part, no further payments will be made. In some cases, a patient may be entitled to only $15,000.00 in medical care if there is a limited policy. If the patient does not own a motor vehicle, the patient could be covered under “resident relative” or “household” coverage or the through the vehicle the patient was traveling in as a passenger.
While coverage could get tricky, you should talk to an experienced New Jersey PIP No-Fault insurance lawyer from our firm, and find out how we can help increase your reimbursements. Call Shaw Kreizer Trial & Injury Lawyers toll free at 1-844-4-DIAL-SK or 1-844-434-2515 or contact us via e-mail for a free consultation at either email@example.com or firstname.lastname@example.org.
Must I obtain prior approval from a PIP insurance company before treating a PIP patient?
State law does require that a medical provider seek pre-certification for insurance benefits; however, approval is not required to move forward with the treatment.
What if the patient caused the accident?
The patient is still covered through PIP insurance.
What types of services does a PIP insurance company pay for?
PIP insurance covers reasonable expenses for medically necessary medical expenses related to the auto collision. Shaw Kreizer Trial & Injury Lawyers have also pursued claims for home care services.
What type of information do I need from the patient before treating the patient?
First, you need to obtain the necessary facts related to the patient’s injuries and the car collision. You should also have the patient sign an “Assignment of Benefits” (AOB) and obtain a copy of their insurance card so you know exactly which insurance company to bill.
Contact Shaw Kreizer and we can provide you sample forms such as an standard AOB, 1st and 2nd Level Appeals, and other documents necessary to pursue reimbursements under NJ PIP No-Fault arbitration, if necessary.
How much can I charge for my services?
The services will be listed on the New Jersey PIP fee schedule; if not, a medical provider is entitled to charge a usual, customary and reasonable (UCR) amount.
Questions are often presented as to the proper coding of a service, what happens when a carrier improper crosswalks your service to another code and you disagree, or the carrier attempts to provide you a different UCR and leaves you with a shortfall. You should talk to an experienced New Jersey PIP No-Fault insurance lawyer from our firm, and find out how we can help increase your reimbursements. Call Shaw Kreizer Trial & Injury Lawyers toll free at 1-800-365-1234 or contact us via e-mail for a free consultation at either email@example.com or firstname.lastname@example.org.
What should I do if the PIP insurance company instructs my patient to attend an Independent Medical Examination (IME)?
Instruct the patient to attend the IME as they are required to cooperate with the insurance company’s request. The patient is allowed to have someone accompany them to the examination, including their treating physician and/or attorney. If the patient does not attend, an insurance company may void the policy or terminate benefits based on the patient’s lack of cooperation.
What should I do if a PIP insurance company reduces my bills?
Talk to Shaw Kreizer! Just because a PIP insurance company tells you it is reducing your bills doesn’t mean that it is legal. Insurance companies reduce bills in most cases for the sole reason of saving money. By accepting insurance premiums from their insured and refusing to pay your bills, they are making money. If an insurance company wants to reduce your bills then give our office a call so we can determine if the reduction is valid. Our office will make this determination free of charge. Call Shaw Kreizer Trial & Injury Lawyers toll free at 1-800-365-1234 or contact us via e-mail for a free consultation at either email@example.com or firstname.lastname@example.org.
What should I do if a PIP insurance company refuses to pay for future treatment?
Again, insurance companies make money by refusing to pay valid bills. Contact our office and let us make the determination. In many cases, the insurance company obtains another doctor’s “independent” opinion in order to deny benefits. Some of these doctor’s, though not all, make their living by wrongfully denying benefits to patients who need treatment. Our office has been successful in exposing these so called “independent” doctors and recovering money for our clients. The Shaw Kreizer Trial & Injury Lawyers regularly oppose IME opinions and seek to prove your treatment was reasonable and medically necessary. If you believe that further treatment is warranted beyond the date the IME determines, you are legally right to continue the treatment.
What should I do if a PIP insurance company requests additional information?
You should cooperate with the request to the best of your ability. If you believe an insurance company is asking for too much information then feel free to contact our office and get our opinion. Again, this is at no charge to you. It is important that you are not harassed or improperly burdened with demands for documentation that is causing non-payments or slow-pay by the insurance carriers. Remember, after 60 days of submitting your bill(s), and unless the carrier requests a one-time 45 day extension, the carrier must determine eligibility and afford a thumbs up or down as to the payment of your bill. You are not required to constantly chase your bill, resubmit your bill over and over again or plead with the insurance company for a response and payment. The Shaw Kreizer Trial & Injury Lawyers will step in and file action on your behalf, at no charge, and place the matter into arbitration where the carrier can no longer ignore its obligations to address your bill(s).
Why should I use Shaw Kreizer Trial & Injury Lawyers to handle my PIP claim?
PIP is a very technical area of law and our office doesn’t charge you an out-of-pocket fee. We only recover money if we are successful at collecting money on your behalf. Judd Shaw has handled thousands of arbitration matters and has collected millions on behalf of his clients. Shaw Krezier has the experience and industry knowledge that gets results. The Shaw Kreizer Trial & Injury Lawyers include attorneys recognized by publications such as Super Lawyers. We have achieved fast settlements for our clients and obtained maximum recovery. Shaw Krezier knows PIP No-Fault. We build relationship with our providers.
You should talk to an experienced New Jersey PIP No-Fault insurance lawyer from our firm, and find out how we can help increase your reimbursements. Call Shaw Kreizer Trial & Injury Lawyers toll free at 1-800-365-1234 or contact us via e-mail for a free consultation at either email@example.com or firstname.lastname@example.org.