In court and in arbitration, there are rules of evidence that must be followed in order to establish a claim.

“Proof of mailing” is proof that a document was sent to the no-fault carrier. Proof that a document was sent to an insurance carrier can come in many forms. The most commonly used are the following:

  • A Certificate of Mailing, which is a US postal form that is stamped by the post office when a document is mailed. When using this form, it is critical to include the patient’s name, policy number, date of service, and amount of bill in dispute.
  • Certified Mail with return receipt
  • Fax Cover letters
  • Affidavit from the person who physically mailed the document (see sample affidavit)

Proof of mailing of the initial bill is important because absent a denial from the carrier (which itself establishes that a claim exists), providers must show that they mailed the bill within 45 days of service to the carrier. If no corresponding denial is in the submission, the carrier will attempt to get the case dismissed without prejudice to allow the bill to be submitted.

Proof of mailing is also essential when responding to a verification requests. Without proof of mailing that a responsive document was sent, an insurance carrier can claim that they never received it. Insurance carriers must also show proof of mailing for the verification requests they send, and accordingly, they have established systems to generate such proof.

WE STRONGLY SUGGEST: Providers should create and establish their own internal systems to track and create proof of mailing for bills and verification responses. It prevents a carrier from asserting, “We never received that”, and using that as a defense to your claim for payment. Keeping detailed proof that documents were mailed may require the expenditure of a small amount of effort and expense, but it will ensure that the case be heard on its merits instead of lost on evidentiary technicalities.

Do you have more questions about collecting on No-Fault Claims in New York State?  We are here to help.

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