New York No Fault Form - NF3

For no-fault accident claims in New York, the NF3, or Verification of Treatment by Attending Physician or Other Provider of Health Services form is required. This form is built into your DrChrono account and is easily accessible through the patient's appointment.

  • Navigate to the patient's appointment
    • Make sure the payment profile is set to Auto Accident. Also, ensure all fields are filled in under the Auto Accident under the patient's insurance section.

  • Select Other Forms on the right side of the screen

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  • Here you can select and print a couple of related forms.
    • HCFA/1500 - This is a regular 1500 form that will print on plain white 8.5" X 11" paper
    • HCFA/1500 (text) - This will print just the text. Select this option if you have the red pre-printed HCFA paper in your printer.
    • New York: C4.3 - Doctor's Report of MMI/Permanent Impairment
    • New York: NF3 - New York Motor Vehicle No-Fault Insurance Law Verification of Treatment by Attending Physician or Other Provider of Health Service

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Motor Vehicle No-Fault Insurance Law Verification of Treatment by Attending Physician or Other Provider of Health Service

  • When you select the NF3 form from the dropdown, many fields will pre-populate if the information is listed in the patient's Auto Accident insurance section. If it is not, or you need to update the information shown, you can click into the box and it will let you free text.

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All patient data listed in this article is sample data. This is not a real person or real patient data.

Source:

https://www.dfs.ny.gov/apps_and_licensing/property_insurers/nofault

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