Billing and coding built only for pain management practices
Robbinsville, NJ
DOCS4DOCS is a pain management medical billing company headquartered in Robbinsville, New Jersey. We handle the parts of NJ billing that trip up general billing companies: PIP and auto accident claims, Decision Point Review precertification, the NJ PIP fee schedule, and out-of-network payment disputes.
Updated
Why New Jersey is different
New Jersey is a no-fault state, so auto injury treatment is billed first to the patient's PIP coverage, with limits that range from $15,000 to $250,000 depending on the policy. Some patients choose their health insurance as primary instead, which changes who you bill first.
Every NJ auto carrier runs a Decision Point Review Plan. Injections, RFA and other pain procedures usually need precertification, and missing it can mean a reduced payment or a denial.
PIP pays pain procedures according to the New Jersey medical fee schedule set by the Department of Banking and Insurance, not your commercial rates. We bill to the schedule and flag underpayments.
Out-of-network claims in New Jersey can fall under the federal No Surprises Act or New Jersey's own out-of-network law, depending on the patient's plan. We identify which process applies and file on time.
NJ PIP billing
Auto accident patients are a large part of many New Jersey pain practices, and PIP claims have their own rules, deadlines and dispute process. We manage each claim from the first visit until it is paid.
Confirm the PIP carrier, policy limit, remaining benefits, deductible and whether health insurance is primary.
Submit Decision Point Review and precertification requests with the documentation the carrier's plan requires.
Code each procedure and bill at the New Jersey PIP fee schedule amount, with an assignment of benefits on file.
Track payment deadlines, file internal appeals on denials and underpayments, and prepare cases for PIP arbitration when needed.
What we cover
FAQ
Yes. We bill New Jersey PIP and auto accident claims for pain management practices, including coverage verification, Decision Point Review precertification, billing to the NJ PIP fee schedule, internal appeals and preparation for PIP arbitration.
Decision Point Review is the process New Jersey auto insurers use to review treatment for accident injuries. Providers must request review or precertification for many services, including most interventional pain procedures, before treating. Skipping it can lead to a reduced payment or a denial.
The provider first files an internal appeal with the auto carrier. If the appeal does not resolve the claim, the dispute can go to PIP arbitration. We handle the appeal and prepare the documentation needed for arbitration.
We bill Medicare through Novitas Solutions, NJ FamilyCare managed care plans, Horizon Blue Cross Blue Shield of New Jersey, national commercial plans such as Aetna, Cigna and UnitedHealthcare, and New Jersey auto and PIP carriers.
Our office is at 2 N Commerce Sq, Ste 308, Robbinsville, NJ 08691, in Mercer County. We work with pain management practices throughout New Jersey and across the United States.
How it works
Tell us about your practice, your payers and where claims are getting stuck. A pain management billing specialist will get back to you and recommend a plan.
Your procedures, payers, billing software and current challenges.
We look at where claims are denied, underpaid or delayed.
We recommend how we can take over or support your revenue cycle.
Get started
Tell us about your practice and we’ll show you where better billing can reduce denials and speed up payment.
Schedule a free consultation. We’ll review your coding, denials and authorizations and show you where DOCS4DOCS can help your pain practice.