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Medical provider claims are one of the most challenging and contentious types of claims in New Jersey workers’ compensation law. They involve disputes between medical providers and employers or insurers over the payment of medical bills for the treatment of injured workers. In this seminar, you will learn how to effectively and efficiently handle the various issues and stages of medical provider claims.
Don’t miss this opportunity to learn from the best and improve your career. Register now and join us for this informative and stimulating seminar!
Course Outline
Who Should Attend?
Pleadings and initial discovery by applicant: What is required for a medical provider to prepare and file a medical provider application for payment or reimbursement of medical charges, and how to conduct initial discovery to obtain relevant information and documents from the respondent.
Defending medical provider claims initial evaluation: How to evaluate the merits and risks of a medical provider claim, and how to decide whether to pay, deny, or negotiate the claim, as well as the procedures and deadlines for filing the answer and counterclaim.
Developing a defense strategy: How to develop and implement a defense strategy for a medical provider claim, and how to use various defense tools and tactics, such as fee schedules, utilization review, medical necessity, causal relationship, and statute of limitations.
The Wottrich case (decided in 2023, argued by Gregory Lois): How to understand and apply the landmark decision of Judge Leitner in the Wottrich case, which clarified the jurisdiction and authority of the Division of Workers' Compensation over medical provider claims, and how to deal with the implications and consequences of this decision for future cases.
This seminar is designed for attorneys, law judges, and risk professionals who want to update their skills and knowledge in New Jersey workers' compensation law. It will provide you with practical tips, techniques, and examples from expert and experienced instructors and speakers. It will also give you the opportunity to interact with your peers and share your cases and issues.
Greg Lois is the Managing Partner of Lois Law Firm LLC. Greg is the co-author of the LexisNexis “Practice Guide to Workers’ Compensation in New Jersey” published by Matthew Bender (2017-2024, ISBN:9781663363053). In October 2019, Greg earned the designation “Certified Litigation Management Professional (CLMP)” at the Litigation Management Institute hosted at Loyola University Chicago School of Law.
Greg Lois represents employers, self-insured companies, third party administrators, and insurance carriers in workers’ compensation matters. Greg has served as lead attorney on more than 100 trials involving workplace discrimination, workers’ compensation, and civil claims.
New York Workers’ Compensation Defense at Lois Law Firm
We represent insurance carriers, self-insured employers, third party claim administrators, and employers before the New York State Workers' Compensation Board. We handle cases from cradle-to-grave. We want to be by your side, moving cases aggressively to closure from the start of litigation all the way through to settlement.
We only assign one attorney and one paralegal to each case. This means that your team members always have one contact to go to for any questions. We do not have 'hearing attorney' or a 'negotiation attorney' or 'appeal department' or anything else! All of our attorneys handle all of those roles – meaning cases are not 'passed around' as they move through the litigation process. Your risk professional or adjuster always knows who is assigned – because the attorney does not change.
