New Jersey Health Providers Filing PIP Insurance Claims Must Use Designated Forms As of April 17

Feb 8, 2017


New Jersey Insurance Commissioner Richard Badolato issued an order today, February 8, 2017, that, effective April 17, 2017, all providers treating patients being treated under Personal Injury Protection insurance coverage must use designated Uniform Pre-Service and Post-Service Appeal forms to submit internal appeals to insurers.

To access the forms and a “Frequently Asked Questions” document, click on the hyperlinks below.

Pre-Service Appeal Form – PDF or MS Excel

Post-Service Appeal Form – PDF or MS Excel

Frequently Asked Questions:  Implementation of Internal Appeal Rule Changes

Order A17-103:  In the Matter of the Establishment of Uniform Pre-Service and Post-Service Internal Appeal Forms


Should you have any questions or comments, please contact Colodny Fass.



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