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The Rogak No-Fault Blog: ** Third Party Billers **CAN A THIRD PARTY BILLER MAKE OUT A PRIMA FACIE CASE IF THE PROVIDER SUPPLIES AN AFFIDAVIT? MAYBE, BUT NOT HERE Read More ...
The Rogak No-Fault Blog: ** IME No-Shows - Voiding of Benefits **FOR FIRST TIME, COURT APPLIES "UNITRIN" AND VOIDS ALL 'FIRST PARTY COVERAGE' BASED ON IME NO SHOWS Read More ...
The Rogak No-Fault Blog: ** Facility Fees for Ambulatory Surgery **TRIAL REQUIRED TO ESTABLISH CORRECT FEE FOR OFFICE BASED SUGERGY FACILITIES Read More ... Tags: Facility Fees, Fee Schedule
The Rogak No-Fault Blog: ** Peer Reviews - Trial **THOUGH PEER DOCTOR DID NOT TESTIFY, STIPPED-IN PEER REPORT PROVIDES BASIS FOR PARTIAL WIN BY INSURER Read More ... Tags: Experts, Peer review, Trial
The Rogak No-Fault Blog: ** Res Judicata - Collateral Estoppel **PRIOR VERDICT HELD NOT TO HAVE RES JUDICATA EFFECT BETWEEN SAME PARTIES FOR DIFFERENT DATES OF SERVICE Read More ...
The Rogak No-Fault Blog: ** Peer Reviews - Summary Judgment **ATTORNEY'S AFFIRMATION ALONE IS NOT ENOUGH TO OPPOSE PEER REVIEW REPORT Read More ... Tags: Peer review, summary judgment
The Rogak No-Fault Blog: ** Outstanding Verification **PROOF OF OUTSTANDING VERIFICATION ENTITLES INSURER TO SUMMARY JUDGMENT, BUT IT TOOK AN APPEAL TO GET IT Read More ... Tags: Outstanding Verification
The Rogak No-Fault Blog: ** Peer Reviews - Summary Judgment **UNREBUTTED PEER REVIEWS WITH FACTUAL BASIS AND MEDICAL RATIONALE ENTITLED INSURER TO SUMMARY JUDGMENT Read More ... Tags: Peer review, summary judgment
The Rogak No-Fault Blog: ** Acupuncture - Fee Schedule **ACUPUNCTURISTS GET PAID AT CHIROPRACTIC FEE SCHEDULE FOR CHIROPRACTORS Read More ... Tags: Acupuncture, Fee Schedule
The Rogak No-Fault Blog: ** Assignments - Revocation **ASSIGNMENTS CAN BE REVOKED, BUT IT HAS TO BE DONE CORRECTLY TO BE VALID Read More ... Tags: Assignments
The Rogak No-Fault Blog: ** Use or Operation **BICYCLIST STRIKES CAR STOPPED FOR SCHOOL BUS; ARBITRATOR HOLDS ACCIDENT AROSE OUT OF VEHICLE'S USE OR OPERATION Read More ... Tags: Assignments, Bicyclists, Use or Operation
The Rogak No-Fault Blog: ** MUA - Collateral Estoppel **THOUGH PRIOR ARBITRATOR FOUND MUA ANESTHESIA NOT MEDICALLY NECESSARY, PRIOR DECISION NOT BINDING ON CHIROPRACTOR'S CLAIM FOR SAME MUA Read More ...
The Rogak No-Fault Blog: ** Fee Schedule - By Report Code **INSURER'S REDUCTION OF CPT CODE 97999 BILLS HELD NOT SPECIFIC ENOUGH Read More ... Tags: Fee Schedule
The Rogak No-Fault Blog: ** IME - Scheduling Letters **MISTAKE IN ADDRESS ON FIRST IME LETTER VOIDS NO-SHOW DEFENSE Read More ... Tags: IME, Scheduling Letters
The Rogak No-Fault Blog: ** Doctors With Suspended Licenses **DOCTOR WITH SUSPENDED LICENSE MAY CONTINUE TO SUE FOR SERVICES PROVIDED BEFORE SUSPENSION Read More ... Tags: Fraudulent Incorporation
The Rogak No-Fault Blog: ** Motion Practice - Amended Motions **YOU CAN'T HAVE A MOTION AND AN AMENDED MOTION AT THE SAME TIME Read More ... Tags: Motion Practice
The Rogak No-Fault Blog: ** Medical Supplies - Prima Facie Case **DESPITE "FAIR PRICE," MEDICAL SUPPLY COMPANY MUST SPECIFY METHOD OF DELIVERY TO MAKE OUT A PRIMA FACIE CASE Read More ... Tags: Medical Supplies, Prima Facie Case
The Rogak No-Fault Blog: ** Acupuncture - Fee Schedule **INSURER ESTABLISHES THAT IT PAID CHIROPRACTOR FOR ACUPUNCTURE AT CORRECT FEE SCHEDULE Read More ... Tags: Acupuncture, Fee Schedule
The Rogak No-Fault Blog: ** Prima Facie Case **UNLESS PLAINTIFF ESTABLISHES THAT BILLS WERE SENT AND NOT TIMELY AND PROPERLY DENIED, INSURER DOES NOT HAVE TO PROVE MAILING OF DENIALS Read More ... Tags: Prima Facie Case
The Rogak No-Fault Blog: ** Defaults - Appeal **WHAT DO YOU DO WHEN A COURT RULES THAT A DEFAULT IS NOT A DEFAULT? Read More ... Tags: Default judgments
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