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Pavlova v. Allstate Insurance Company

Civil Court of the City of New York, Kings County

December 18, 2017

Ksenia Pavlova, D.O. a/a/o Cosby Reavis, Plaintiff,
v.
Allstate Insurance Company, Defendant.

          For Plaintiff: The Rybak Firm, PLLC

          For Defendant: Peter C. Merani, P.C.

          DEVIN P. COHEN ACTING JUSTICE, SUPREME COURT.

         Recitation, as required by CPLR §2219 (a), of the papers considered in the review of this Motion

         Papers/Numbered

         Notice of Motion and Affidavits Annexed 1

         Order to Show Cause and Affidavits Annexed

         Answering Affidavits 2

         Replying Affidavits

         Exhibits

         Other

         Plaintiff's motion to reargue its motion for summary judgment is decided as follows:

In this action to recover assigned first-party no-fault benefits, plaintiff submitted a claim form and invoice to defendant for services rendered to Cosby Reavis on October 8, 2013. According to plaintiff's claim, these services related to various codes promulgated under the Official New York Workers' Compensation Medical Fee Schedule (the "Fee Schedule"), including 20999, which is a "By Report" Code. Defendant denied plaintiff's claim in part because plaintiff did not bill its services in accordance with the applicable fee schedule. Plaintiff filed the instant action and both parties moved for summary judgment.

         With specific regard to plaintiff's motion to reargue, this court denied plaintiff's motion for summary judgment with respect to plaintiff's claim for payment under Code 20999. The court reasoned that, because Code 20999 is a "By Report" code, plaintiff was required to submit certain information about the services provided in order to establish a proper billing rate as part of its prima facie case. Plaintiff did not ...


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