About Us

Insurance carriers deny claims for reasons such as:

• IME no-show
• Missing or unanswered verification
• Fee schedule reductions
• Medical necessity disputes
• Coding issues or missing documentation
• EUO requests
• Coverage disputes or late notice

If your claim was denied, litigation may allow you to recover full payment plus interest.

Yes. 
Our firm focuses on no-fault litigation because it often produces higher recoveries and greater leverage. 
If a provider prefers arbitration, we will still file it. 

Just three items:

• The bill (CMS-1500 or UB-04)
• The denial (NF-10/EOB), if you have it
• A brief summary of the claim

No medical records are required at intake.

Many cases settle early after filing. 
Cases that require motions or trial calendars take longer. 
Providers and billing companies get regular updates and can track all cases through our 24/7 secure portal. 

No. Unlike some attorneys, we do not charge providers any upfront fees. 
No-fault matters are fee-shifting, meaning the insurance company pays our legal fee when we win. 

You receive:

• Direct access to the attorney
• Fast responses
• A secure online portal

We prioritize efficient, transparent communication.

We represent:

• Orthopedic surgeons
• Neurologists
• Pain management physicians
• Chiropractors
• Physical & occupational therapists
• Acupuncturists
• Surgical centers
• Radiology and diagnostic facilities
• Home care providers
• Billing companies handling no-fault claims

• 25+ years of no-fault litigation experience
• Litigation-first strategy for stronger results
• Clear communication
• Fast, easy case filing
• Mastery of NY fee schedules & verification rules
• Deep experience handling IME, EUO, and medical necessity disputes

Yes—throughout all five boroughs, Nassau & Suffolk, Westchester, Rockland, and upstate counties. 

• 15 business days to send an initial request
• 10 days for a follow-up request

These deadlines are strict under New York no-fault law.

If the insurer can’t prove proper mailing, the denial is often invalid.
Mailing defects are one of the most successful litigation arguments in no-fault.

Providers should submit bills within 45 days of service.

The insurer must prove:

• Proper mailing of both IME notices
• Timely scheduling
• Affidavit of non-appearance
• A valid denial issued within 30 days

IME issues are among the most litigated areas in New York no-fault.

The denial becomes precluded, meaning the carrier cannot raise most defenses such as:

• Fee schedule reductions
• Medical necessity
• IME no-show defenses

This is a major advantage for providers in litigation.

Providers have up to 120 days to respond to verification requests.

In litigation, interest begins the day the lawsuit is filed.

The insurer must pay or deny within 30 days after receiving all outstanding verification.

Six (6) years for most claims.
Self-insureds and municipal entities may have a shorter statute of limitations —
contact us if you believe your claim falls under one of these exceptions.

Yes.
Each provider has a separate, independent claim under New York no-fault law.

All claims must follow the NY Workers’ Compensation Fee Schedule, including:

• Correct regional rates
• Proper CPT/HCPCS coding
• Accurate RVU calculations
• Correct use of modifiers

Fee schedule reductions are one of the most commonly overturned denials in litigation.

No.
Broad or nonspecific verification requests do not toll the carrier’s 30-day deadline.

Yes, but each must be timely and compliant.
A single late request breaks the entire chain.

New York uses the Workers’ Compensation Fee Schedule for:

• Office visits (E/M)
• PT/OT/Chiropractic
• Radiology
• Surgery & global periods
• Modifiers (-25, -59, -50, etc.)

Carrier errors in fee schedule calculations are extremely common.

Hospitals: DRG-based or per diem billing on UB-04
Providers: CPT-based fee schedule on CMS-1500

Common issues include improper DRG repricing and applying provider rules to hospital bills.

Carriers may request EUOs for:

• High-frequency treatment
• Suspicious documentation
• Billing spikes
• Multi-specialty same-day visits
• Complex accident circumstances

Proper scheduling, mailing, and compliance rules are strictly enforced in litigation.

To process patient wage loss claims, carriers require:

• NF-2
• Employer wage verification
• Disability notes
• Pay records (W-2s, stubs, tax docs)

We assist patients with documentation, follow-ups, and litigation when necessary.

Trials may involve:

• IME doctors
• Peer review authors
• Adjusters
• Billing experts
• Mailing/verification witnesses

We handle all trial preparation and court strategy.

Carriers frequently attempt to:

• Delay verification
• Use vague requests
• Misapply the fee schedule
• Issue boilerplate denials
• Schedule improper IMEs
• Claim late submission without proof

We counter these with strict enforcement of New York no-fault regulations, aggressive discovery, and statutory interest leverage.