New Jersey no-fault utilization review/NJ auto policy decision point review
Under the provisions of the NJ auto policy and New Jersey regulations, decision point reviews and/or pre-certification of specified medical treatment and testing is required, for medically necessary expenses to be fully reimbursable under the policy. The New Jersey Department of Banking and Insurance has published standard courses of treatment for soft tissue injuries of the neck and back. These are called care paths and provide medical providers with general guidelines for treatment and diagnostic testing. The care paths include requirements that medical providers consult with us at certain stages in your treatment. These are called decision point reviews. For a copy of The Hanover forms and access to our company's retained administrator of Utilization Review, Medlogix,. The forms in the link below will provide an overview of pre-certification and decision point requirements. For policyholders, please read your policy, policy terms and conditions for the actual pre-certification and decision point requirements.