Coder’s affidavit is sufficient to prove non-conformity with the fee schedule

If you were injured due to someone else’s careless actions, we understand the challenges you may be facing. As a victim or a surviving family member, you could be dealing with the life-altering consequences of a serious accident.

GBI Acupuncture, P.C. v 21st Century Ins. Co., 2015 NY Slip Op 51235(U)(App. Term 2d Dept. 2015)

“Furthermore, the affidavit executed by defendant’s certified professional coder established that defendant had properly used the workers’ compensation fee schedule to determine the amount which plaintiff was entitled to receive for the services at issue”

I am sensing this case (among a few others) might cut into the argument (more so raised at arbitration) that the affidavit of the coder is insufficient to reduce the fee charged since the coder is not a medical professional.

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