New York's highest court of appeals has held that no-fault insurers cannot deny no-fault benefits where they unilaterally determine that a provider has committed misconduct based upon alleged fraudulent conduct. The Court held that this authority belongs solely to state regulators, specifically New York's Board of Regents, which oversees professional licensing and discipline. This follows a similar recent ruling in Florida reported in this publication.
Ask the Billing Expert
Samuel A. Collins
Samuel A. Collins is an expert in chiropractic insurance billing for the H.J. Ross Network, a consulting group for doctors on billing and collection for insurance claims. His background is in the chiropractic profession, where he supervised a high-volume chiropractic clinic for 16 years. You are encouraged to submit billing questions to Mr. Collins at sam@hjrossnetwork.com. Your question may be the subject of a future column.