First Aid Occupational Therapy, PLLC v Country-Wide Ins. Co., 2010 NY Slip Op 50594(U)(App. Term 2d Dept. 2010)
“Defendant also established that it had timely denied the two $182.84 and three $523.20 claims on the ground that the services for which payment was sought were part of another service and, thus, were not separately reimbursable (see St. Vincent Med. Care, P.C. v Country-Wide Ins. Co., 26 Misc 3d 58 [App Term, 2d, 11th & 13th Jud Dists 2009]), and defendant’s opposition papers were sufficient to raise a triable issue of fact with respect thereto. Consequently, neither party was entitled to summary judgment on the first, seventh and eighth causes of action, as well as so much of the third cause of action as sought to recover upon the $523.20 claim.”
I have posted on this issue previously. Again, I do not generally believe that the range of motion testing is included in the office visit as the insurance carrier has been arguing in these cases.
