What is PIP Arbitration

What is PIP Arbitration

PIP arbitration is a legal process that allows doctors and medical providers to recoup their outstanding medical bills from automobile insurance companies. First, in order for Morch Law, LLC to file an arbitration, an assignment of benefits must be signed by the patient. Second, the invoices must be appealed. If the medical invoice is improperly reimbursed or is outstanding for more than 60 days, it is over-due and Morch Law, LLC can file the arbitration on your behalf.

To file an arbitration

If you are having trouble filling an arbitration form, please contact us via e-mail and we will be glad to assist you.

What is needed to file NJ PIP No-Fault arbitration:

  • The Assignment of Benefits Form
  • The Itemized Invoices
  • The NJ PIP No-Fault Pre-service and Post-service Appeals with fax confirmations

What does improperly reimbursed mean?

  • Unpaid medical bill.
  • Improperly reimbursed bill (pre-certification penalty applied incorrectly).
  • Multiple modality reduction applied incorrectly.
  • Bill denied for medical necessity.
  • Fails to pay usual and customary or reasonable rate for treatment, not on the NJ PIP Fee Schedule.
  • PPO reduction applied incorrectly.

Improperly Reimbursements

If you are having trouble filling an arbitration form, please contact us via e-mail and we will be glad to assist you.

Documents

Check List for Arbitration

Required information for arbitration process

New Jersey PIP No-Fault Pre-Service Appeal Form

There are three reasons to submit NJ PIP No-Fault Pre-Service Appeal Form:
Untimely response by carrier to pre-certification
Administrative Dispute
Medical Necessity Dispute

New Jersey PIP No-Fault Post-Service Appeal Form

After a denial, a NJ PIP No-Fault Post-Service Appeal Form must be submitted 45 days prior to filing an arbitration.

Requirement for Insurer Internal Appeal Procedure

As of April 17, 2017, the NJ No-Fault PIP Appeals Process has Changed. The new process was stated in NJAC 11:3-4.7B Requirement for insurer Internal Appeal procedure document.