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New Jersey Department of Banking & Insurance
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Medical Benefits Precertification Process/ Decision Point Review Plan:
• DPR Plan effective 11/15/17
• DPR Plan effective 9/1/17
• DPR Plan effective 4/17/17
• NJPLIGA Conditional Assignment of Benefits
• Uniform Attending Provider Treatment Plan Form
• PIP Pre-Service Appeals Form
• PIP Post-Service Appeals Form
• Surgery Precertification Request for NJ No Fault Claims Form
• Find a NJ Auto Voluntary Network Provider
• Find a Workers' Compensation Provider
• Find a Pharmacy Provider
• National Correct Coding Initiative Edits
2016 Annual Report
2016 Recoupment Order
United Southern Assurance Company
Fla Dept Ins Div Of Rehab. & Liquid.
2020 Cap. Cir. S.E. Alexander Bldg 310
Tallahassee,
FL
32301
(800) 882-3054
Supporting Documents