Irina Acupuncture, P.C., v. Nationwide Affinity Insurance Company, 57 Misc.3d 146 Insurer must demand an EUO of the provider withing 30 days of receipt of the bills/claim. Civil Court properly granted the branches of plaintiff’s motion seeking summary judgment on the first two causes of ac
American Chiropractic Care, P.C. v. Geico, 57 Misc3d 529 (2017) The relevant dicta is as follows: In an action for no-fault benefits, defendant insurer was obligated to demonstrate a good faith basis for the examination under oath (EUO) of plaintiff medical provider in response to plaintiff’s time
Allstate Insurance Co. v. Longevity Medical Supply, Inc., 2272/16 (Civ. Ct. NY Co. 2016) The initial bill was mailed to an address not associated with submission of bills for Allstate Insurance Company. Allstate argued that it was sent to the wrong address for No-Fault correspondence. Provider los
Blackman v. Allstate Ins. Co., 26470/15, NYLJ 1202775250364 The Court ruled that when a provider bills a BR code, burden of proving the merits of the service pursuant to ground rule 10 to support the service only shifts to provider when a verification request is issued by the insurer. This diver
As part As part of its 2017 Medicare Physician Fee Schedule update, the Center for Medicare and Medicaid Services (CMS) reissued its prohibition on certain unit-based rental arrangements with referring physicians, adopted updates to the list of CPT/HCPCS codes (Code List) defining certain of the St
High Quality Medical Supplies, Inc., v. Mercury Ins. Group, 2016 N.Y. Slip Op. 51444(U) It appears that the Plaintiff medical supply company billed for something not specifically set forth in the fee schedule the Court said as follows in a short decision: In this action by a provider to recover ass
KEW GARDENS MED AND REHAB, P.C., v. COUNTRY–WIDE INSURANCE COMPANY, 52 Misc. 3d 143 Plaintiff commenced a PIP action in April 2002. In 2014, the Civil Court granted plaintiff’s motion for summary judgment and directed that the judgment for $5,255.74 in principal and $15,457.93 in statutory i
In Liberty Mutual Ins. Co v. Branch Med., P.C., 2016 NY Slip Op 31706(U), http://www.leagle.com/decision/In%20NYCO%2020160916409/LIBERTY%20MUT.%20INS.%20CO.%20v.%20BRANCH%20MED.,%20P.C. Defendants are licensed physicians sued by the insurer based on Mallela allegations stemming from their alleged
Does this case show that a party can invoke the arbitration clause in a contract and stay litigation? In ST. Chiropractic, P.C. v. Geico General Ins. Co., NYLJ 1202766695437 http://law.justia.com/cases/new-york/appellate-term-second-department/2016/2016-ny-slip-op-26271.html. Plaintiff assignor
Hu-Nam-Nam, M.D., v. New York Central Mutual Fire Insurance Company, — N.Y.S.3d —-, 2016 WL 4020542 (N.Y.Sup.App.Term), 2016 N.Y. Slip Op. 26237 Insurer moved for summary judgment dismissing the complaint on the basis that it had timely and properly denied plaintiff’s claim based on