Precertification Hours of Operation in NJ
Pursuant to the Governor’s Executive Order 107, insurers were directed to exercise appropriate forbearance on collection, documentation, and other regulatory requirements, including due dates for claims filings and prior authorization requests. We have provided notice that our failure to respond to Precertification requests made during the recent storm is not an acknowledgement of medical necessity. Should you wish to proceed with the proposed medical treatment, your bill will be retrospectively reviewed for medical necessity. You also have the option of resubmitting your request.
Due to Superstorm Sandy, our Precertification fax number was out of service from 10/29/12 through 11/6/12. Despite any confirmations you may have received, we will be exercising the Executive Order to those faxes.
*On 11/7/12, our Precertification fax line 732-978-7100 was restored and Decision Point Review faxes received from that date and on will be addressed within three business days; appeals within ten business days.
You may fax your requests to 732-978-7100 or utilize our Precertification mailbox:
Plymouth Rock Assurance
PO Box 907
Lincroft, NJ 07738
PLEASE NOTE: You may have received a fax from an outbound machine only. Please do not fax any Precertification requests to this number.
Should you have any questions, our medical management department can be reached at 888-814-6397, Monday through Friday between 8:00 am and 5:00 pm.
For additional information regarding Medical Protocols Rules, Automobile Medical Fee Schedule, PIP Alternative Dispute Resolution, Prompt Pay Regulation Information and 21 Day Notice Rule you may reference the Department of Banking and Insurance webpage: PIP Information for Health Care Providers at www.state.nj.us/dobi/pipinfo/aicrapg.htm.
Our Wall, New Jersey hours of operation are Monday through Friday from 8:00 am until 5:00 pm. Requests for Precertification and Decision Point Review treatment received outside of normal business hours will be recorded as received on the next business day. Precertification and Decision Point Review requests will be responded to within three business days.
Plymouth Rock Assurance Company observes the following holidays and will be closed for business on the following days in 2014:
- New Year’s Day
- Martin Luther King Jr. Day
- Presidents' Day
- Memorial Day
- Independence Day
- Labor Day
- Thanksgiving Day
- The day after Thanksgiving
- Christmas Day
- The day after Christmas