Regarding today's Rogak Report decision, (11-3-03) I have a question.
I'm not sure of the specific facts of this case, but did the carrier
initially issue a denial to the medical provider and insured for
excessive treatment? Or was the denial only to the insured? I have
had instances where I have recommended that a no-fault carrier not
respond to every bill submitted by the same medical facility
repeatedly. Example; A claimant is denied due to concurrent care
and/or an IME. The denial is sent to the claimant, his or her
attorney, the main doctor, and all other treating providers. The
provider whose bills are denied still submits bills months after
receiving the denial from the carrier. A letter is sent advising him
that the bills will not be paid, and enclosing a copy of the
previously sent denials. Can he prevail in litigation if an NF-10 was
not resent in response to every single bill submitted?
According to the dissenting judge in the Rogak report today, this is
redundant. I happen to agree, but my question is this-Was the
deciding factor in this decision the fact that the NF-10 was not sent
to the medical provider, or that it was not continually sent as bills
were being submitted?