NYS Form NF-3:

Verification of Treatment by Attending Physician or Other Provider of Health Service


Healthcare providers have 45 days from the date of treatment to produce and submit no-fault medical bills to insurance companies. According to the current No-Fault Insurance regulations, all no-fault medical treatment bills must be created on the prescribed No-Fault Verification of Treatment Form (“NF-3”).  (Please note, however, that office-based surgery centers and/or Article 28 facility bills must be submitted on the UB-04.)


The NF-3 requires the physician to input basic information about the patient and his or her no-fault coverage, including: the name of the no-fault policyholder and the policy number; the date of accident; the claim number; the patient’s name, address, date of birth, and sex; the physician’s diagnosis; and the date of the patient’s initial visit.

The physician also includes in the NF-3 a report of the services rendered.  The report includes: the dates of service; the place services were rendered; a description of the treatments or health services rendered; the applicable fee schedule treatment code; and the charge for each treatment.  The treating provider’s name, license/certification number, and business relationship to the healthcare facility is also included.

In addition, the NF-3 includes the same language as contained in an Assignment of Benefits (“AOB”) form, where the patient chooses to assign the healthcare provider all rights, privileges, and remedies to payment for services rendered by the provider.  The form also specifies that the assignment may be revoked by the provider when benefits aren’t payable based on the patient’s lack of no-fault coverage and/or a violation of a policy condition due to the actions or conduct of the patient.

Our Services

We produce no-fault bills using the NF-3 on a daily basis, based on the treatment rendered by the physician. To ensure that all no-fault medical bills are produced and submitted within 45 days of each date of service, our no-fault billing software is programmed to follow a 30-day rule. This provides a 15-day window to address unforeseen circumstances, and ensures that no-fault bills are never submitted late.

After producing bills using the NF-3, the bills are then queued in a “Review Folder.”  Physicians can access these bills online using an encrypted connection, which allows them to review the bills, sign the bills, and then release them for printing. Most physicians using our no-fault billing service do this on a weekly basis.

Once the physician reviews the claims, the claims are queued for printing. We then make sure that all necessary notes—for example, trigger point injection and physical therapy notes—are attached to the bills and signed. All NF-3s are then printed, grouped by individual insurance companies, and sent timely within 45 days of the date of treatment.

We are specialists in no-fault billing and collection.  To learn more from us about the NF-3 Form, please call (516) 427-5400 for an immediate, free consultation.