N.J. Admin. Code § 11:3-25.4

Current through Register Vol. 56, No. 21, November 4, 2024

Section 11:3-25.4 - Content of notice and proof of receipt

(a) The treating health care provider shall send the written notice required by 11:3-25.3(a) to the PIP insurer on either:

1. The "Notification of Commencement of Medical Treatment Form" found in Appendix A, appended to and incorporated by reference in this subchapter; or

2. A bill or invoice rendered by the treating health care provider that includes at a minimum the information required in the "Notification of Commencement of Medical Treatment Form" in Appendix A.

(b) When any notice required by this subchapter is mailed, the postmark shall be the proof of mailing. The insurer shall retain evidence of untimely mailing of the notice whenever it denies or reduces payment pursuant to 11:3-25.5.

(c) In those cases where facsimile or E-mail notice is authorized by the insurer when any notice required by this subchapter is sent by facsimile or by E-mail, the proof of notice shall be the facsimile transmission receipt generated by the sender's facsimile machine, a copy of the E-mail message showing the date and time of transmittal or an acknowledgment of receipt generated by the receiving system. Nothing in this section shall prohibit treating health care providers and insurers from mutually agreeing to accept other proofs of notice for electronic transmissions. It shall be the responsibility of the treating health care provider to retain proof of notice of commencement of treatment transmitted by facsimile or other electronic means.

(d) Any notice given pursuant to this subchapter shall be deemed to have been made on the date of postmark or the date of transmission in the case of facsimile transmission and E-mail.

(e) When a bill or invoice is used to provide notice of the commencement of treatment in accordance with this subchapter, it shall not be deemed to constitute notice unless the following message appears on the first page of the bill or invoice: "21 DAY NOTICE" or "FIRST BILL 21 DAY NOTICE." This message shall be in contrasting color ink and be in at least 12 point capital letters. Use of a rubber stamp or affixed label is acceptable for purposes of complying with this subsection.

N.J. Admin. Code § 11:3-25.4

Amended by R.1998 d.591, effective 12/21/1998 (operative March 22, 1999).
See: 30 New Jersey Register 3202(a), 30 New Jersey Register 4390(b).
In (a) and (c), substituted references to health care providers for references to medical providers; and added (e).