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The Hartford fax number

(866) 771-6001

New Jersey No-Fault/PIP Medical Billing Precertification (Decision Point Review)

Used for: Precertification submission for NJ No-Fault/PIP medical services; initiation of the Decision Point Review (DPR) process; submission of Uniform Pre-Service and Post-Service Appeals Forms when applicable

Fax destination details

Department
New Jersey No-Fault/PIP Medical Billing Precertification (Decision Point Review)
Purpose
Precertification submission for NJ No-Fault/PIP medical services; initiation of the Decision Point Review (DPR) process; submission of Uniform Pre-Service and Post-Service Appeals Forms when applicable
Form
New Jersey Pre-Service and Post-Service Appeals Forms — New Jersey Pre-Service and Post-Service Appeals Forms
Address
P.O. Box 14269, Lexington, KY 40512
Voice phone
800-280-0555

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Submit the NJ pre-service or post-service appeal forms to The Hartford via fax at 866-771-6001; include the claim number and supporting documentation; see NJ DOBI DPR Plan for details

Official form instructions are published as a downloadable file on the organization's website.

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