Author: George A. David, PA

The presumption of prejudice can be shattered if the medical provider can present evidence that the insurance company’s investigation was not destroyed. Many times insurance companies like to make medical providers believe that if the insured fails to appear to

Both chiropractors and orthopedic surgeons alike will perform manual muscle testing billed under either CPT codes 95851 or 95832 along with a 99205, 99204 or 99203 office visits. Insurance companies regularly deny manual muscle testing CPT codes on the grounds

Most insurance companies do not understand what triggers an insured’s appearance to an examination under oath or giving a statement. One of an insurance company’s favorite methods of wiggling out of coverage is a material misrepresenta- tion defense. A material

A PIP payout log is by no means the end-all to be all to what the insurance company paid. In exhaustion of benefits cases, the best practice to truly verify of benefits are exhausted is to review explanations of review

In a recent decision, the Florida Supreme Court actually strengthened the billed amount statute of FS §627.736(5)(a)(5) which states: “An insurer may limit payment as authorized by this paragraph only if the insurance policy includes a notice at the time

I have noticed recently an alarming high rate of PIP claims being denied by various insurance companies based on a patient not receiving treatment within 14 days of the date of the accident. It seems to me that insurance companies