nager romaine & schneiberg attorneys

What Happens if My Work Injury Medical Bills Are Submitted to My Insurance Company?

Workers’ compensation is intended to cover medical bills and lost income from work-related injuries. When you suffer a workplace injury, you may need medical treatment before your workers’ compensation claim is approved. Since many people cannot afford to pay medical bills out of pocket, you may feel obligated to submit your own insurance information. What does that mean for your compensation? Do you have to put off necessary medical treatment in order to get reimbursed?

Will I be reimbursed for treatment before my claim is approved?

The Ohio Bureau of Workers’ Compensation (BWC) requires that workers visit a BWC-approved provider for on-the-job injuries. If the provider is not BWC certified, payment may be denied. The BWC will pay for their medical bills when the claim is approved. However, when someone requires emergency or otherwise urgent treatment, they may not have the luxury of looking up BWC-approved providers. Clients often wonder if that means they’re stuck with these early medical bills incurred before their claim is approved.

When you seek treatment, make sure all of your medical providers know that your injury is due to a work-related accident. Whether it’s an urgent care provider, emergency room, or another healthcare provider, they need to know you suffered a workplace injury.

If you use your own insurance to pay for treatment before claim approval, your insurance company will likely reach out to you to determine if it’s a work-related injury. They may not cover work-related injuries. If your health insurance company is billed for the treatment, the workers’ compensation insurance provider may reimburse them.

It is important to know that there are time limitations for submitting medical bills. Ohio Revised Code 4123.52(B) prohibits payment for medical bills when they are submitted more than one year after the date the services were rendered or the date services become payable under RC 4123.511.

If you find yourself in this frustrating situation, call a workers’ compensation attorney at NRS as soon as possible. Our attorneys can help you understand which bills you may be obligated to pay, which are covered by workers’ compensation, and where there may be conflicts.

What happens if my BWC-approved provider sends me bills?

Generally, when you visit an approved provider, they should send the bills directly to the workers’ compensation insurer. If you receive bills from the provider, you should contact them as soon as possible to inform them of the mistake. Should they persist, your NRS workers’ compensation attorney will be happy to handle the error on your behalf.

Medical bills are costly, and you shouldn’t have to pay work-related medical bills out of pocket. Contact the Workers’ Compensation Team at Nager, Romaine, & Schneiberg Co. LPA today for assistance with your claim.

Disclaimer: The information in this blog post (“post”) is provided for general informational purposes only, and may not reflect the current law in your jurisdiction. No information contained in this post should be construed as legal advice, nor is it intended to be a substitute for legal counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this Post without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from a lawyer licensed in the recipient’s state, country or other appropriate licensing jurisdiction.
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