Medical providers and billing managers must carefully scrutinize ALL payments for reductions to your billed charges. If you see an “allowed amount” as being $0, or anything that indicates the charge will not be paid, mark it for review, as there is a potential issue. If you see services being down coded or otherwise changed by the insurer, that is a reduction ripe for demand. If your patient is sent for an IME and benefits are subsequently suspended, that is a claim ripe for demand. Essentially, anytime the EOBs/EORs indicate no payment you have a likely issue for PIP arbitration. While a small percentage are legitimate denials (i.e., no coverage), the majority are not; so when in doubt, ask us. Medical providers and billing manager should be particularly mindful of when claims are past-due. EOBs/EORs are sometimes not sent and a claim could go unpaid for months and years without explanation. Once 60 days have passed, if no payment is received and there are no EOBs/EORs explaining the nonpayment, the claim is ripe for demand.