New Jersey No-Fault PIP Arbitration Lawyers
At SK Law, we know how difficult it can be for medical providers like you to get fair payment from PIP insurance companies for the services you provide. We want to help. Our legal team can review your patient files for underpayments and help identify instances of underpayment. We’ll even scan the necessary paperwork into our secured server and help build an internal PIP No-Fault workflow (or collaborate with your existing process) to establish a consistent PIP cash flow.
Judd Shaw, managing partner at SK Law, has collected millions on behalf of clients over more than a decade of practicing law. With his guidance, our firm’s New Jersey PIP No-Fault Arbitration Department has the talent and experience to obtain huge results.
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. Call 1-866-909-6894 or contact us online to get help now. Your initial consultation is free, and you only pay us for our services if you get paid. That’s our No Fee Guarantee®.
What type of medical providers seek New Jersey No-Fault benefits?
SK Law personally serves a wide variety of healthcare clients, including:
- multi-disciplinary practices
- physicians and physician groups
- ambulatory care facilities
- diagnostic facilities
- skilled or certified practitioners
- billing managers
- supply care companies
Due to our lawyers’ substantial experience in the New Jersey and New York No-Fault Arbitration process, SK Law is often called upon to assist in navigating through the alternative dispute resolution process, including challenging or enforcing arbitration awards.
Our team of lawyers monitors the industry’s ever-changing healthcare regulations, orders, bulletins, and case law, as well as changes in medical technology—particularly in the areas of spinal surgery techniques and MRI testing guidelines.
Our experience includes highly regulated specialty areas of particular interest to the healthcare industry, such as issues regarding:
- payment and reimbursement matters
- licensure and certification and coverage
Talk to an experienced New Jersey PIP No-Fault insurance lawyer from our firm now to find out how we can help increase your reimbursements. Call SK Law at 1-866-909-6894 or complete our free online form to get started 24 hours a day, 7 days a week.
Important New Jersey 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 here.
- 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 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.
- Forthright now allows claims under $1,000 to be filed without an oral hearing, which means faster end dates and quicker resolutions.
- A copy of Forthright’s Amended Rules Effective April 15, 2013, can be found here, along with an overview of the NJ PIP arbitration process and answers to frequently asked questions.
SK Law provides free, complimentary on-site consultations and assistance and can assist in executing your internal appeals process, which is required by insurance companies through their Decision Point Review Plans. Our team will monitor your files for the earliest filing date to help get your matter into the pipeline as fast as possible before the insurance benefits exhaust under the policies.
Case Management Technology That Keeps Clients Informed 24/7
We believe in maintaining open communication with our clients. Our team is always available by phone or email to answer 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 a.m. to 7 p.m.
SK Law also recognizes that you want to keep up-to-date with the status of your files, so we created a client portal that allows live, accurate, and current information, 24/7. Our clients can “virtually look into” their files anytime and are notified electronically when their file moves to the next stage of the Forthright process.
Security is important, and our system delivers bank-grade encryption to ensure your data stays safe. Clients are capable of managing all referrals, in real time, and in one central location, from any computer. With search technology, a dashboard reveals critical information we know is important to our clients.
We find that our clients enjoy receiving our eStatus Update Notifications and it frees them up from requesting statuses or information on a certain matter.
Collaborate With Our Legal Team Using the PIP-App© Portal
Until now, no other web-based legal software was designed exclusively for PIP No-Fault arbitration practice. SK Law holds an exclusive subscription with a PIP No-Fault arbitration software system that aims to redefine the way work gets done, address key industry challenges, and spark the true capabilities of the firm’s clients.
Our software was designed from the ground up to:
- incorporate bank-grade security
- include a 24/7 client web portal
- provide real time status notifications
- integrate internal management tools
- offer secure service and support tailored to the needs of our clients
Forthright operates electronically with online and mobile access. The SK Law PIP No-Fault arbitration team aims to bring the same kind of transformation to the way we work and perform, so that we can operate seamlessly with Forthright’s electronic solutions.
What is the process for New Jersey No-Fault PIP arbitration?
When a PIP insurance company either refuses to make a 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.
As the Claimant, you file a Demand for Arbitration with Forthright in accordance with Forthright’s NJ No-Fault PIP Arbitration Rules. The demand could seek 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, 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. SK Law regularly appears statewide and before all DRPs in the north, central, and southern regions of New Jersey. For in-person proceedings, Forthright will set a date, time, and location for the hearing. The SK Law 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 DRP and present their evidence. The DRP considers the parties’ evidence and issues a written decision within 45 days from the closing date. At an on-the-papers proceeding, the parties will submit briefs and a DRP will render a decision without oral arguments.
Our law firm’s process follows Forthright’s Roadmap, but does so electronically, which provides for faster service to clients. Whether you provide matters by hard copy or email, paperwork is scanned into our firm’s secure computer network, eliminating the need for follow-up requests for paperwork.
No Recovery For You, No Recovery For Us
SK Law 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 we 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 New Jersey PIP No-Fault Demand for Arbitration against an insurance company, then state law requires the insurance company to pay for our attorney’s fees. We never charge medical providers for our attorney’s fees.
What is Personal Injury Protection (PIP)? +
For medical providers looking to provide treatment to NJ automobile accident victims, 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, 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, benefits are 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” coverage, “household” coverage, or through the vehicle the patient was traveling in as a passenger.
Questions about PIP coverage? Contact SK Law anytime. We’re here to help, and your initial consultation is always free. Dial 1-866-909-6894 or contact us online to get started now.
Must I obtain prior approval from a PIP insurance company before treating a PIP patient? +
State law requires that a medical provider seek pre-certification for insurance benefits. However, approval is not required to move forward with the treatment.
What if a patient caused the motor vehicle 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. SK Law has 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 SK Law and we can provide you sample forms such as a standard AOB, first and second 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 improperly crosswalks your service to another code and you disagree, or when the carrier attempts to provide you a different UCR and leaves you with a shortfall.
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 SK Law! Just because a PIP insurance company tells you it is reducing your bills doesn’t mean that what they are doing 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, give our legal team a call so we can determine if the reduction is valid. SK Law will make this determination free of charge. Call 1-866-909-6894 or contact us online today to get started.
What should I do if a PIP insurance company refuses to pay for future treatment? +
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 to deny benefits. Some of these doctors, 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 attorneys at SK Law 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, feel free to contact our office and get our opinion 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. After 60 days following the submission of your bill(s), 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. SK Law 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 SK Law 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, our firm’s managing partner, has handled thousands of arbitration matters, and he has collected millions on behalf of his clients.
SK Law has the experience and industry knowledge to help clients like you get results. Our team includes attorneys recognized by publications such as Super Lawyers. We have achieved fast settlements for our clients and obtained maximum recovery, and we want to help you find out if we can help increase your reimbursements.