Records Review Must Be Submitted to Like-Kind Practitioner
Boston and all Massachusetts practitioners licensed under Massachusetts General Laws, chapter 112 now have a recent Appellate court decision that alters reimbursement for auto accidents, bicycle accidents, pedestrian accidents and all such cases reimbursed through PIP. The Appellate Division has changed the way Massachusetts insurers are allowed to submit medical bills for review and thus calculate amounts paid to providers. The attorney’s at the Boston Law Office of Neil Burns want our clients to stay current on changing PIP practices.
In a case where Premier Insurance refused to pay 20% of the medical bills of an injured plaintiff, after it submitted the bills to an “outside” company for review, the Court found that there was no proof that they actually did submit the bills to an outside company. Wherefore, the Court found against Premier and ordered them to pay the bills. See Howard Physical Therapy, Inc. v. Premier Insurance Co. (Appellate Division, Northern District) (App. Div. No. 10-ADMS-10029) (Sept. 23, 2010).