We seem to have had a rash of no-fault claim debacles. We call New York
State no-fault for prior authorization, are told “no-fault does not
pre-authorize, it’s an “open case”, go ahead and provide the services”.
We did that, and we were hit with every delay tactic imaginable,
including but not limited to requests for “provider invoices”, and even
one refusal to pay for services provided, after the fact (and being told
to go ahead and provide it !!!). We contacted the NYS Insurance
Department per the one denial, and they recommended that we bill
no-fault, but not provide the services until we are paid. Can we legally
do that? Has anyone run into similar problems with no-fault? Any
suggestions?
Thanks,
Mike Madden, BOC, C.Ped
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