Form C-8.4 Notice to Health Care Provider and Injured Worker of a Carrier's Refusal to Pay All (Or a Portion of) a Medical Bill Due to Valuation Objection(S) - New York

What Is Form C-8.4?

This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form C-8.4?
A: Form C-8.4 is a notice used in New York to inform health care providers and injured workers that an insurance carrier has refused to pay all or part of a medical bill due to valuation objections.

Q: When is Form C-8.4 used?
A: Form C-8.4 is used when an insurance carrier in New York refuses to pay all or part of a medical bill due to valuation objections.

Q: Who receives Form C-8.4?
A: Form C-8.4 is sent to both the health care provider and the injured worker.

Q: What does Form C-8.4 inform the recipient about?
A: Form C-8.4 informs the recipient that the insurance carrier has refused to pay all or a portion of a medical bill and provides the reasons for the refusal.

Q: Why would an insurance carrier refuse to pay a medical bill?
A: An insurance carrier may refuse to pay a medical bill due to valuation objections, which means they believe the bill is priced incorrectly or not within the usual and customary fees for similar services.

Q: What should the recipient of Form C-8.4 do?
A: The recipient should review the reasons provided for the refusal and may choose to dispute the carrier's decision.

Q: Is there a specific deadline for responding to Form C-8.4?
A: The form does not specify a deadline for responding, but it is generally advisable to address the issue promptly to avoid potential complications.

Q: Is Form C-8.4 applicable in both the US and Canada?
A: No, Form C-8.4 is specific to the state of New York in the United States.