CPAN, in conjunction with its General Counsel legal team at Sinas Dramis, present The No-fault Provider Survival Course. This course will be offered over several dates in a half-day virtual format.
Major changes to Michigan’s auto no-fault law enacted in 2019 have altered and limited the scope and extent of the PIP allowable expense benefits. Additionally, the new law made significant changes regarding tort liability claims. These 2019 changes in the law made filing claims overly complicated, with several important rules and requirements that must be followed in order to protect the legal rights of crash victims. It is imperative that providers rendering care to these patients covered by no-fault insurance thoroughly understand these differences. Medical providers are subject to “fee schedules," accreditation requirements, utilization review rules, and other oversights previously not required before the 2019 changes limiting covered services for patients.
The No-Fault Provider Survival Course is designed to help providers understand these changes and help them navigate the new rules and requirements imposed by the law. The course discusses the following 10 rules for provider protections:
1. Determine applicable PIP Coverage Limits and Opt-Outs
2. Determine the Proper Payor of PIP Benefits
3. Know the Applicable Fee Schedules
4. Appreciate the Reasonable Change Problem
5. Submit Compliant and Timely Notice of Claims
6. Understand the New Utilization Review Process and Follow DIFS’ Rules
7. Understand Addition Restrictions on Care
8. Watch Out for Insurance Medical Exams
9. Protect the New Provider Cause of Action and Set-Up Penalty Sanctions
10. Recognize the Importance of the Tort Case
Included with the course registration is a comprehensive “binder” of materials which registrants can either obtain digitally or in an easy-to-reference color copy, hard copy, tabbed binder. The 16 tabbed sections include a copy of the No-Fault Auto Insurance Act, a “Protecting the Injured: Summary Guide," CPAN’s Making Smart Choices: Recommendations, CPAN's no-fault vs Medicare and Medicaid comparison coverage chart, DIFS Bulletins, Spectrum Health Hospital v Farm Bureau Case and case summary, Utilization Review Rules and summary timeline, Provider Appeal Request form, DIFS Accreditation requirements and FAQs, and “Tort Becomes PIP: The New Right to Recover Excess ‘Allowable Expenses from At-Fault Drivers” – article by Stephen Sinas.
