No Fault insurance carriers have a responsibility to pay a medical treatment claim that is without issue in 30 days time from receipt of the claim . Make sure you keep an official record of mailing proof - whether it be certified mailing or claims mailed out on all your no fault patients in a mailbook log officially date stamped by your local post office.
Don't get comfortable with the numerous delay tactics sent out by insurance carriers. When you are told by the insurance claim rep. in a sweet, calm tone that "the claim was processed and the check is in the mail" ... for two months straight- it is time to file your official written complaint.
I actually communicate on a regular basis with one particular carrier who refuses to pay any claim sent in -until they hear from me via the New York State Department of Financial Services . When I have sent everything in twice -by mail and fax and made my follow up phone call to the carrier - in which there is never a written or verbal response given - I file a complaint online requesting assistance for this claim to now be paid with interest. I attach all my proof to the complaint sent in . Thanks to today's technology, The Department of Financial Services gets my online complaint to the insurance carrier the same day. My phone rings from the carrier later that same day for me to finally hear the spoken words, " Hey Julie, I got your message today. " :*) This is how we communicate. This is how I get the claim paid . It is a sad truth, but truth nonetheless and I am very thankful that the majority of complaints I filed this year with The Department of Financial Services were rapidly and successfully handled. (JP)
Click link below to file a complaint at the Department of Financial Services.
Complaint Link
You can file a No Fault, Workers Compensation or Prompt Pay Complaint using our Online Complaint Form. You will receive immediate confirmation and be assigned a file number.
You will have one hour to process the complaint form. If you do not complete the form within one hour you will be prompted to refresh and the information you have entered before refreshing will be lost.
The form will contain a series of questions. If you do not understand any of the requested information, you can click on the question and a help box will appear to offer an additional description.
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