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<br />" <br /> <br />" <br /> <br />Section 262.14 Provider and Beneficf.. <br />Insurance <br /> <br /> <br />With Res ect to NO"Fa", <br /> <br />Thi. new .ection eXplain. that where thero i. a possibility of no-fault Inoura"o <br />coverage, no Modicare payment. ore mode unlo.. the provider or benefic/.." ho <br />e.housted the claim. proce.. under no-foult in.urance. A. previou.ly ototed "I, <br />this bulletin, claim. without ovidence that tho no-fault insurance corrior We, <br />billed first will be denied. <br /> <br />Section 262. 15 Private, Ri~lit of Action <br /> <br />\ <br /> <br />\ . <br />This new section provides that ony cloimant hos the right to toke oction .g"not <br />o no-foult inourer that foil. to poy primary. Any beneficlory has the right t.o <br />. to ke legol oction ogoln.t the respon.ible entity thot foil. to poy primary bon.f1t, <br />~nd can collect double d.m_ges. <br /> <br />. Procedure for lnvestic;ation of Tr.aum. Codes <br /> <br />There ore range. of ICD-9-CM code. thot mOYinvolvo covorase undor no-foult <br />in.uronce. Attochment 2 io 0 1I0ting of th..o oodeo. WIlenever "ne "of tho.. <br />code. Oppears on the claim_ the cloim will ou.pend to the Medic~re Secondo'Y <br />P~yer Unit for review. At this point,. ~ development 'etter will be. generated <br />to the provider requesting whether Or not the services relate to .n .accident. <br />The claim. may be denied if the provider does not rupond to the development <br />letter. <br /> <br />The Medic"e Secondary Payer Unit will no longer be roquo.ting medical record. <br />on tnesa claims. <br /> <br />This change will be effective with any claim. received beginning NOvl!n7b.... 1, <br />1990. <br /> <br />I f you have iny questions concerning this bulletin. please contict one of cur <br />Cu s tomer Service Represent.tives ..t (612) 456-5.503 or toll free at <br />1-800-382-2000, exten~;on 5503. <br /> <br />rm2 J 1 <br /> <br />"~; <br />