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The Office of General Counsel issued the following informal opinion on January 3, 2002, representing the position of the New York State Insurance Department.

Re: No-Fault NF-10 Forms

Question Presented:

Must the prescribed No-Fault Form NF-10, utilized by No-Fault insurers when issuing a denial of claim, be printed on yellow paper?

Conclusion:

No. There is no such requirement.

Facts:

The inquirer indicated that a managed care company, working on behalf of certain No-Fault insurers, processes a significant amount of bills submitted to these insurers by health care providers for the payment of No-Fault benefits. It is the company's responsibility to process such bills and reduce the health service fees charged by the providers to the maximum permissible rates established under the No-Fault fee schedule when necessary, as well as to generate an Explanation of Benefits letter and a Denial of Claim form ("NF-10") when the fee amounts are reduced.

It has been the company's customary practice to print these NF-10 forms on yellow paper for the use of insurers when issuing denials (i.e. fee reductions) for health services rendered. To accommodate a new Windows based bill review product for the system usage the company would like to use white paper for reasons of efficiency.

Analysis:

Although it has been the custom of some insurers to issue NF-10 forms on yellow paper, in order to highlight the denials to claimants, there is no requirement under No-Fault that these forms be printed in yellow. Therefore, there is no impediment to the company's use of white paper instead.

For further information you may contact Supervising Attorney Lawrence M. Fuchsberg at the New York City Office.

 

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