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EMR/EHR No-Fault Software
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No-Fault Billing & Collections
Workers’ Compensation Billing & Collections
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EMR/EHR No-Fault Software
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Resources
No-Fault Resources
Complete set of no-fault forms
Arbitration Request Form (AR-1)
New York Motor Vehicle No-Fault Insurance Law Cover Letter
Application For Motor Vehicle No-Fault Benefits (NF-2)
Verification Of Treatment By Attending Physician Or Other Provider Of Health Service (NF-3)
Verification Of Hospital Treatment (NF-4)
Hospital Facility Form (NF-5)
Employer’s Wage Verification Report (NF-6)
Verification Of Self-Employment Income (NF-7)
Agreement To Pursue Social Security Disability Benefits (NF-8)
Agreement To Pursue Workers’ Compensation Or N.Y.S. Disability Benefits (NF-9)
Denial Of Claim Form (NF-10)
Additional PIP Subrogation Agreement (NF-11)
Lump-Sum Settlement Agreement (NF-12)
Election Of Option – Optional Basic Economic Loss Coverage (NF-13)
No-Fault Insurance Law Assignment Of Benefits Form (AOB)
Workers' Compensation Resources
HIPPA Authorization for Release of Health Information
Affidavit of No Insurance
New York State Department of Motor Vehicles Accident Report (MV 104)
New York State Workers’ Compensation Board Employee’s Claim for Compensation (C-3)
GreenBills Brochure
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