Your workers’ compensation claim was approved, and you're getting the medical treatment you need to recover from a work-related injury.
Suddenly, you're billed for something that workers' comp benefits should have covered. Why did this happen, and what can you do about it? Let me explain.
Even After Approval, You Have to Follow BWC Rules
Once your claim is approved by the Bureau of Workers’ Compensation (BWC), your employer’s managed care organization (MCO) will take over handling the application, including paying the provider for your medical care.
However, if you fail to do any of the following, your medical bills may not be paid:
- Go to an approved provider. After your initial visit to a doctor or ER after an injury, all follow-up treatment must be provided by a BWC-certified doctor. You can get a list of approved providers from your employer or the BWC. If you select a doctor who isn't BWC-certified, workers’ comp won't pay for the visit.
- Tell the provider you're being treated for a work-related injury. At every appointment, make sure the doctor and the staff know you're being treated for an injury that happened in the workplace and that the visit should be billed to the BWC. If you don’t do this and the bill is sent to your private insurance, it's difficult to fix it.
- Apply for additional allowances. Your doctor may decide that new symptoms are related to the initial work injury, but you must apply to the MCO for additional allowances before any treatment is covered by workers’ comp.
- Get pre-approval for new treatments. Attending physicians have to request approval for any treatment plan they recommend. If the request is denied, you can appeal, but the treatment won't be covered in the meantime.
Your BWC-certified doctor and your MCO should help you avoid making mistakes that would lead to non-payment of a legitimate claim. However, they're not always helpful. If you're having problems getting bills paid, an Ohio workers’ comp attorney may help.
Bring Your Questions to Monast Law Office
If you're struggling with bills you shouldn’t be responsible for, contact my office to talk to my team. We may help you undo billing mistakes and get the BWC payment you deserve. To learn more about your right to workers’ compensation, request a free download of our book, The Worker’s Guide to Injury Compensation in Ohio.