Frequently, insurance carriers will deny a healthcare provider's claim on the ground that the procedures, tests, or medical supplies were not medically necessary, even though they really were.
An Independent Medical Examination (IME) doctor, like a peer review doctor, is hired by the insurance carrier. And, like the peer review doctor, he earns a substantial fee in exchange for performing the IME for the insurance carrier.
The insurance carrier's right to examine a No-Fault medical provider under oath arose from State Farm Mut. Auto Ins. Co. v Mallela (4 NY3d 313). An EUO is a formal proceeding, which takes place before a court reporter and is memorialized in a transcript.
New York insurance law provides that charges by health service providers may not be greater than the schedules prepared by the workers's compensation board.