No Fault Recovery

The Odierno Law Firm has successfully represented over six hundred medical providers in obtaining no-fault benefits prematurely denied by insurance companies. We are able to recover no-fault benefits denied for the following reasons:

EUOs

An examination under oath (EUO) is a pre-litigation discovery device that allows the insurance company to obtain information through sworn testimony of the injured party and/or treating medical provider regarding the pending No-Fault claim. The deponent has the right to have an attorney present during the examination. The Odierno Law Firm, P.C. has represented medical providers during an EUO hearing and strongly recommends an attorney be present during any EUO hearing. We recover all no-fault bills that have been denied due EUO testimony or alleged noncompliance with an EUO. Please contact us immediately if you receive an EUO scheduling letter requiring you to appear for testimony.

Partial Pay/ Fee Schedule

In some instances No-Fault insurance companies will reduce payments based upon their interpretation of the fee schedule, other usual and customary rates, or licensing.  In addition there are many ground rules within the fee code that can affect the rate a no-fault provider is reimbursed.  In many instances, however, the rates or fees the insurance companies apply are incorrect.  If a no-fault provider receives partial payment The Odierno Law Firm P.C. will assist them in recovering the unpaid portion of their bills.

Peer Review Denials

A majority of our no-fault litigation is based upon peer review and post IME denials. A peer review denial is an opinion by a medical doctor hired by an insurance company that the services in question were not medically necessary and therefore not reimbursable. The doctor does not examine the injured party, but merely reviews medical records. The Odierno Law Firm, P.C. has successfully litigated thousands of peer review denial cases by expertly analyzing the peer report and records. Once the deficiencies in the peer report are identified and the doctor thereafter discredited we recover the fees improperly denied to the provider.

Post IME Treatment

No-Fault insurance companies regularly use an independent medical examination (IME) to determine if the injured party is still in need of medical treatment.  The IME is performed by a doctor hired by the insurance company who physically examines the injured party to determine if future treatment is warranted.   If the IME physician determines that no further treatment is necessary, the insurance company will issue a denial terminating future no-fault benefits. This denial does not mean the provider must stop treating the insured. It is within the provider's rights to disagree with the IME by continuing to render medically necessary treatment and submit bills to the No-Fault insurance company. The Odierno Law Firm will recover the bills submitted by the provider after No-Fault benefits have been terminated.