ROCKAWAY BLVD. v. Progressive

EDGAR G. WALKER, J. billed for. If the treating provider was an employee of the billing provider, the billing provider would be considered a provider of services, through its employee, and thereby entitled under the regulation to direct payment. If, however, the treating provider was an independent contractor, the billing provider would not be entitled to direct payment under the regulation since it did not provide services to the applicant patient. The significance of the information required by item 16 of form N-F 3 is apparent. It relates directly to the right of the billing provider to receive direct payment from the insurer as the assignee of the applicant. At least where, as in this case, the billing provider is not the treating provider, the submission of form 1500 does not constitute a complete proof of claim. Since plaintiff did not submit a proper proof of claim, it failed to establish a prima facie case of entitlement to payment of no-fault benefits. The motion must, therefore, be denied regardless of the sufficiency of the opposing papers. (Alvarez v Prospect Hosp., 68 NY2d 320 [1986].) [*] Although there are two named plaintiffs in the caption, the moving papers make no reference to Jamil M. Abraham M.D. P.C., doing business as Park Health Center. As used herein "plaintiff" refers solely to Rockaway Boulevard Medical P.C., doing business as Queens Diagnostic Center.