Our Practice

The Sigalov Firm PLLC specializes in the collection and arbitration of no-fault medical claims

Our Practice

The Sigalov Firm PLLC focuses on the collection and arbitration of no-fault healthcare claims.

We have handled thousands of claims with outstanding results for our clients – medical doctors, chiropractors, surgical centers and medical supply providers.

Arbitration is frequently the most effective way to recover moneys, but we are fully prepared to litigate when necessary.

Medical Necessity

Frequently, insurance carriers will deny a healthcare provider’s claim on the ground that the procedures, tests, or medical supplies were not medically necessary, even though they really were.

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IME No-show

IME no-shows are a frequent problem for medical providers seeking reimbursement. Injured persons are expected to present themselves for an examination at the time and place of the insurance carrier’s choosing.

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IME Cut-off

An Independent Medical Examination (IME) doctor, like a peer review doctor, is hired by the insurance carrier. And, like the peer review doctor, he earns a substantial fee in exchange for performing the IME for the insurance carrier.

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Examination Under Oath (EUO)

The insurance carrier’s right to examine a No-Fault medical provider under oath arose from State Farm Mut. Auto Ins. Co. v Mallela (4 NY3d 313). An EUO is a formal proceeding, which takes place before a court reporter and is memorialized in a transcript.

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45-Day Rule

Generally, bills for reimbursement of services must be submitted within 45 days from the date of service. This is commonly known as the 45-day rule.

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Fee-schedule

New York insurance law provides that charges by health service providers may not be greater than the schedules prepared by the workers’s compensation board.

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