New Jersey PIP Medical Collections

It is no secret that New Jersey’s Personal Injury Protection laws are confusing. Medical providers can have trouble getting adequately reimbursed by insurance companies without going through several technical and time-consuming obstacles.

At the New Jersey Law Office of James W. Taylor, Jr, we have established a reputation for excellence over several decades by providing maximum personal injury protection benefits to medical clients in New Jersey. We have the skill and experience to take on even the most complex PIP cases and maximize your PIP reimbursement. Contact us today to learn more.

Putting New Jersey PIP Regulations to Work for You

What is the maximum amount a medical provider may charge or be reimbursed?

In 1990, the New Jersey Commissioner of Insurance was required to set maximum reimbursement rates for specific medical procedures and services. As a result, the New Jersey Fee Schedule was created based on the fair and prevailing rates of 75% of the providers in a specific area of the state.

The New Jersey Fee Schedule appears in the New Jersey Administrative Code at NJAC § 11:3-29.4. The reimbursement rate for a particular charge is determined by the three different regions of the state in which a provider practices. The American Medical Association assigns a code based on its current procedural terminology (CPT) system for certain medical procedures.

The New Jersey Fee Schedule lists CPT codes for some medical procedures; however, others are not. If a procedure is listed on the fee schedule, payment for that procedure will be based on its CPT code listing.

When a procedure’s CPT code is not addressed within the New Jersey Fee Schedule, the Act stipulates that an insurer’s limit of liability:

“…shall be a reasonable amount considering the fee schedule amount for similar services or equipment in the region where the service or equipment was provided for, in the case of elective services or equipment provided outside the state, the region in which the insured resides. Where the fee schedule does not contain a reference to similar services or equipment, the insurer’s limit of liability for any medical expense benefit for any service or equipment not outlined in the fee schedule shall not exceed the usual, customary, and reasonable fee.”[1]

The “usual, customary, and reasonable fee” is determined by you as the medical provider. In other words, you are in control of what you charge for your services, and we can help ensure that you are reimbursed for your charges.

Contact The Law Office of James W. Taylor, Jr., for Maximum PIP Reimbursement In New Jersey

PIP and no-fault insurance are designed to pay for medical expenses regardless of who was responsible for the accident. We understand that filing a claim with an insurance company can be frustrating, and we hope to make the process easier for you.

For patients with PIP or no-fault insurance, our New Jersey arbitration attorney can help you get the reimbursement that is rightfully yours.

We will help you gather the documents and evidence needed to file your claim with the insurance company and negotiate to get you the compensation you deserve. In addition, if the insurance company refuses your claim or offers an inadequate payment, we will fight for you in arbitration.

We Can Help

If you are a medical provider who has treated an accident victim, contact The Law Office of James W. Taylor, Jr., to learn how we can help recover compensation on your behalf. Call The Law Office of James W. Taylor, Jr. at 201-418-0143 or send us a message to book a free consultation today.

We are proud to serve New Jersey residents in Jersey City, Newark, Bayonne, Paterson, Hackensack, and the other surrounding areas in state.