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What is PIP Arbitration?

Many auto accident victims seek medical care following an accident. Unfortunately, because of the complexities of New Jersey’s legal system, the medical providers who provide care can often be left in limbo in pursuit of payment. PIP Arbitration is a process that allows medical providers and insurance companies to resolve disputes and collect owed compensation.

Who Is Responsible for Car Accident Victim Payments?

While it is the victim who receives the medical care, they are not often the one who is responsible for the payment. Because New Jersey is a no-fault state, who is responsible for the accident does not matter. Instead, the injured seek reimbursement through their insurance provider. This also means that the medical provider receives payment through the insurance company.

So, what do you do when the insurance company takes forever to pay? What about when they question the value or need of services received? The PIP arbitration process is the most common method of collecting unpaid bills for medical providers. When you work with a lawyer, they can help you navigate this useful process.

How Can Medical Providers Ensure That Services Will be Paid?

As an auto accident medical provider, it is important that you meet New Jersey’s laws regarding PIP insurance to ensure that you are paid for all services. This includes things like:

  • Billing services at a reasonable rate or as listed in the New Jersey PIP Fee Schedule. 
  • Medical services are Pre-Certified by the PIP insurance provider
  • Billing must be submitted using approved codes
  • A demand letter must be sent to begin the Arbitration process

However, it is important to note that, you may be able to receive payment for medically-necessary services, even if they were not pre-certified. You will need to prove that the service was required. These are just a few of the requirements. It can also be helpful to work with a lawyer to ensure that you meet each of the requirements.

What You Can Expect During the Arbitration Process

Once you and your lawyer have decided to go through the arbitration process to pursue payment, you can expect a few things to happen:

  • Your lawyer will send a demand letter with the filing fee to the insurance company
  • A Dispute Resolution Professional will schedule an in-person hearing
  • You will discuss your complaints or disagreements regarding payment
  • The DRP will issue a ruling

In some cases, you may be able to file an appeal with the New Jersey Superior Court, if you do not agree with the initial ruling.

Reasons to Work With a PIP Lawyer

New Jersey’s laws can be confusing, especially when it comes to the PIP arbitration process. In addition to strict timelines for filing paperwork, it is also important to know the laws in detail, so you can argue your side of the case effectively. A PIP lawyer who is familiar with these laws will help you determine the reason you have not yet received payment, and then fight to collect compensation on your behalf.

Contact A PIP Arbitration Attorney for a Consultation About Your Hudson County Case in New Jersey

Have you completed medical services that you are still awaiting payment for in the state of New Jersey? Then you need to talk to an experienced PIP arbitration lawyer as soon as possible for guidance on how to proceed. The Hudson County attorneys at Birkhold & Maider, LLC are prepared to assist you with your legal claim. We represent medical providers seeking reimbursement for completed services throughout New Jersey including Essex County, Hudson County, Mercer County, and Union County. Call us today at 973-784-8583 or fill out our online contact form to schedule a consultation. Our main office is located at  189 Franklin Avenue, Suite 1, Nutley, NJ 07110 and we also have an office in Hamilton, NJ.

The articles on this blog are for informative purposes only and are no substitute for legal advice or an attorney-client relationship. If you are seeking legal advice, please contact our law firm directly.

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