Eligible $250,000 “Medical Expenses”
“Medical expenses” is defined as “reasonable and necessary expenses for treatment or services as provided by the policy, including medical, surgical, rehabilitative and diagnostic services and hospital expenses, provided by a health care provider licensed or certified by the state or by another state or nation, and reasonable and necessary expensesfor ambulance services or other transportation, medication and other services as may be provided for, ...and also including any non-medical or remedial treatment rendered in accordance with a recognized religious method of healing.”

To be payable by PIP, medical expenses must be reasonable and “medically necessary”
“Medically necessary” is defined as “that the treatment is consistent with the symptoms or diagnosis, and treatment of the injury (1) is not primarily for the convenience of the injured person or provider, (2) is the most appropriate standard or level of service which is in accordance with standards of good practice and standard professional treatment protocols..., and (3) does not involve unnecessary diagnostic testing.”

Notice of claim

The car insurance process begins with filing the Notice of Claim. Learn about the process of filing the the notice of claim and when must the company start paying for the benefits?

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Pre-certification

What is Pre-certification and decision point review?

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What can a medical provider charge/be reimbursed?

The amount that a provider can be reimbursed for a certain charge is broken down into three different regions of the state.

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Resolution of disputes

If an insured or medical provider seeks the recovery of bills which were denied or “underpaid”?

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