Florida Work Injury Lawyers, Franks, Koenig & Neuwelt
We received a call from a frantic workers’ compensation client the other day. The client was receiving collection notices because the workers’ compensation carrier was not paying medical bills following a work related surgery.
The role of workers’ compensation in Florida is to pay for medical care related to an industrial accident. It is not an injured worker’s duty to pay for medical care. You certainly shouldn’t have to worry that your credit will be lowered because work comp can’t do their job.
Unfortunately, we see this a lot. It usually happens under three main situations.
The first situation is when an injured worker receives a bill for a balance of medical services following partial payment by workers’ compensation. Typically, when a doctor agrees to accept workers’ compensation patients, the doctor agrees to accept payment at a reduced rate based on what is called a “fee schedule” (for more information on fee schedules, contact a financial advisor). This is a reduced rate for medical services. This rate is typically well under the amount of money these medical providers normally charge. This fee schedule actually allows workers’ compensation insurance companies to spend less on medical services as compared to a private insurance policy or Medicare or Medicaid. Though the doctor only gets paid a fraction of what they charge, they agree to accept this rate usually in the expectation that they will be sent many work comp patients.
So back to the doctor who charged, say $1,000.00 for an office visit, but only gets paid $100.00 by the workers’ compensation carrier. What do they do? They should eat the loss as agreed to when they agreed to the workers’ compensation fee schedule. However, some medical providers will actually send the injured worker a bill requesting payment of the unpaid balance (this can be an accident, but more often it isn’t).
The injured worker isn’t going to be able to pay the medical bill. They have been out of work for likely many months and the only income they receive is a check from workers’ compensation at a percentage of their pre-injury wages. Soon, the bill will be sent to collections and their credit will be ruined.
As workers’ compensation attorneys, we know how to handle these situations. We can resolve these billing disputes before the medical bills make their way to the collection agencies. And if a medical provider provides a bill for payment of medical services knowing the workers’ compensation carrier is the responsible party, the billing provider may actually be liable for damages and owe the injured worker money.
The second, and most common occurrence of injured workers receiving medical bills, is when medical providers do not know that the need for treatment was due to a workers’ compensation accident or injury. These providers typically include either first responders like ambulances, EMS services or trauma hawk flights or hospital departments that bill separately from the hospital itself.
Many people think that when you go to a hospital you just get one big bill. But this is not correct. As work comp injury lawyers in Florida, we see examples where the emergency room may be advised that the patient is treating under work comp, but the Radiology department, the Pathology (blood work) department or the emergency room treating doctor may not know to bill work comp. All they have is the injured worker’s information, so that’s who they bill for their time or services.
Our experienced work injury compensation lawyers are able to contact the medical providers and provide them with workers’ compensation’s billing information so that the proper parties are billed. This allows the injured worker to concentrate on getting better rather than stress out wondering how to pay for medical care or avoid collection notices.
The third type of billing issue happens after a settlement has been reached. Many injured workers settle their case knowing that some of their medical services have not been paid for at the time of the settlement. The parties agree that the medical bills will be paid by the work comp carrier upon receipt. However, there are many times when these bills are not paid. If they never get paid, and if the injured worker continues to receive bills for these services, your Florida workers’ compensation attorney can file a Motion to Enforce the settlement agreement and get the bill paid regardless of how long it has been after the settlement has been finalized.
There is absolutely no excuse for improper billing when the medical providers have the correct information. We make sure that the billing provider has the injured worker’s workers’ compensation information and advise the work comp adjuster of the need for payment. If, after these steps are made, the bills or collection notices continue we can proceed with a claim in work comp, refer the issue to the Agency for Health Care Administration or file a claim directly against the wrongful party.
If you’ve been involved in an accident at work, contact our Florida Work Injury Lawyers today.