Medical records for a New Jersey car accident injury claim

Which medical records do you need for an injury claim in New Jersey?

You need records from every place that treated or billed you: EMS, the ER, follow-up doctors, imaging, your health plan and your PIP insurer.

The police report records the crash, not your injuries. See how to get your New Jersey car accident report and claiming lost wages after a crash.

Where does "just keep your records" fall short?

It assumes one file and one bill. In practice the paperwork splits three ways, and each split can leave a gap in your claim.

• The ER, the imaging center, your follow-up doctor and your health plan each keep separate files, so one request never gets everything.
• A request for visit notes may not include the itemized bill. Name both, plus the date range.
• A new statement is often the same bill again, not a new expense. Log one line per service, not per statement.

How do you get copies of your medical records and bills?

Ask each provider and your health plan in writing; federal HIPAA rules give you a right to copies of your medical and billing records.

• A provider may charge reasonable copying and mailing costs, but no fee for searching for or retrieving your records.
• If your record is wrong, ask for an amendment. If the provider disagrees, you can add a statement of disagreement.
• Before you leave the ER, ask where to get today's records and the itemized bill.²

For what else to ask and watch for that first night, see what to do in the first 24 hours after a crash. Before you send records to the other driver's insurer, read what to expect from an insurance adjuster.

How do you read an itemized bill PIP only partly paid?

Read it line by line, because PIP pays each listed service under DOBI's fee schedule and can refuse one line while paying the rest.

In a 2019 appeals ruling against NJM, a surgery center billed PIP $13,582. The court held the discography part was not payable at that facility, because the fee schedule did not list it there.

A provider balance does not show that your PIP has run out, or that you owe the full amount. Who pays the hospital and what happens above your limit are on PIP coverage limits and medical bills.³

Which records does the certifying doctor read?

To sue for pain and suffering on the cheaper lawsuit option, a doctor must certify a permanent injury from your records.

That doctor reads your treating notes and imaging reports. A missing or late expert report can end the claim, which happened in 3 of the 13 threshold appeals we read.⁴

What the certification must show is on how to prove pain and suffering in NJ, and the deadlines on how long you have to sue in NJ. The cases are summarized in our New Jersey car accident appeals index.

How do you track medical bills and symptoms after a crash?

Keep one line per service in a bill log, so a repeat statement never looks like a new expense.

Keep the log going for as long as PIP pays. If your health plan pays first, keep its statements too, as PIP or health insurance first explains.

For symptom notes, write the date you wrote it, the date it happened, the ordinary task and what changed. Example: "Written on the 13th about the 12th: reaching to the kitchen shelf hurt, so I asked for help."