No-Fault Claims: The 45-Day Rule

For anyone treating patients involved in motor vehicle accidents, it’s vital to be aware of the 45-day rule.
This rule applies to no-fault insurance claims, which aim to provide coverage for medical expenses that
arise from an accident.

Under the 45-day rule, medical providers only have 45 days from the date of service to submit a claim to
the no-fault insurance carrier. Failure to submit the claim within this time frame could result in the claim
being denied. Once denied, this leaves the provider without payment for any services rendered. Without
satisfactory explanation for a late claim, this denial can be permanent.

To ensure timely submission of claims, providers should set established procedures to keep track of
dates of service as well as any claims already submitted. In addition, including information such as the
date of service, the diagnosis, and treatment provided is crucial. Alternatively, working with a billing
specialist or a third-party billing service may be beneficial.

While the 45-day rule may seem like an additional burden, it ensures medical providers receive fair
compensation for services rendered. By understanding and complying with this rule, providers can help
ensure that their patients receive the care they need without financial hardship, as well as ensure
prompt payment for their services.