Request #19-1670

Our Client: Mosir Beauchard D/Incident: 05/28/2019 D/Birth: 06/18/1981 Location: NW 1st Ave at NW 33rd St Time: 6:15 PM
Dear Sir/Madam:
This office represents Mosir Beauchard for injuries sustained on or about 05/28/2019. I understand that our client was treated or transported by fire rescue. Please forward all FIRE RESCUE REPORTS AND ITEMIZED BILLS, in electronic format ONLY, for our client from 05/28/2019 to the present. Please see attached Hi-Tech request and HIPAA as required . Electronic Delivery options:
 Fax #: (866) 323-5485  Email:  Online Portal: Please provide link and access information as needed.  USB or CD format
If you do not receive proper payment from the PIP insurer, please contact us immediately as our office will handle any PIP claims arising from this accident. If you received any payments from health insurance, please make all required contractual adjustments.
Thank you in advance for your prompt attention to this matter. Should you have any questions, please contact me.
Mixa Hernandez Pre-Litigation Assistant MH/MS Encl.


June 10, 2019 via email







Point of Contact

Alberto Diaz

Department Assignment Public
June 11, 2019, 12:38pm
Request Opened Public
Request received via email
June 11, 2019, 12:38pm