In New York, you are required to seek medical attention from a no-fault doctor if you seek medical services due to a No-Fault auto accident. A common mistake many people make is assuming their family physician qualifies. Even if your primary physician is qualified to provide services for No-Fault injuries, they may specialize in treating auto accident victims, so it may be a good idea to seek the services of one who does. When looking for a no-fault qualified physician’s office, it is often a good idea to also look for a multi-specialty medical practice. Multi-specialty physicians’ offices have integrated teams that can provide and coordinate a wide variety of services that may be required for someone that has been in an auto accident, including physical therapy, pain management, chiropractic care, physiatry, orthopedic care, and more.
One of the advantages of working with a no-fault physician is if you need to be referred for diagnostic testing such as nerve conduction tests, X-rays, or MRIs, they have experience working with providers of these services that qualify to be covered.
Another advantage of working with a doctor who is qualified to treat No-Fault accident patients and specializes in the area is they are very familiar with the documentation required when providing services. These specialists will ensure the correct documentation is provided at the initial visit, follow-up, diagnostic appointment, and other treatment appointments. This is essential in developing a detailed medical record showing the extent of your injury and their relationship to the auto accident. This documentation is critical when working with a no-fault attorney who may be assisting you with pursuing damages for injury or loss of wages.
Services covered by your No-Fault Insurance in New York
The no-fault insurance policy you have covers medical expenses related to injuries that occurred in your auto accident, including but not limited to:
- Medical costs associated with doctor’s visits
- Some of your wages lost if you are too injured to return to work right away
- Medical transportation
- Durable Medical Equipment
- Prescription medications
- In-home nursing home or aide assistance if your doctor deems them necessary
For medical services to be eligible for reimbursement under New York No-Fault law, the services must be medically necessary health services as enumerated under N. Y. Ins. Law § 5102 (McKinney 2000) and subject to the requirements of No-Fault Regulation 68, N.Y. Comp. Codes R. & Regs. Tit. 11 § 65.15 when applicable.
The medical expenses submitted to your no-fault insurance company are paid at the negotiated no-fault rate. You will not be held responsible for any difference between what your doctor bills the insurance company and what the no-fault insurance company pays them.
Park Avenue Trauma’s physicians assist patients suffering from job-related injuries, i.e., New York State Workers’ Compensation claims. Our well-trained staff of medical doctors, physical therapists, and administrative personnel are dedicated to providing our patients with the highest quality care available.