I fell about 6 weeks ago at work, and I've been to the doctor 3 times for my back. Tomorrow I go for an MRI and I start physical therapy next week. I've been turning everything in on my insurance because I didn't think I could get worker's comp, but I got my paperwork today. So, the doctor doesn't know I'm going to turn it in on worker's comp. My question is, if I continue putting everything on insurance, can the worker's comp claim go backwards and reimburse the insurance/my deductible? I have an appointment in the morning for my MRI and i'm not sure if I should tell them it's going to be worker's comp, or leave it on insurance for now. Please help! Thanks!
2007-09-18 12:32:22 · 2 answers · asked by Kris 2 in Business & Finance ➔ Insurance
You need to tell them right away that it is workers compensation.
When your insurance company finds out that you have been approved for a workers comp claim, they will take back all of the payments already given to the doctor. (And trust me - they will find out. With a back injury, they'll certainly review claims to see if there is workers comp involved.) You don't want your doctor's office to be caught off guard by that - just give them the workers compensation info and take care of it ASAP.
What will happen is that your insurance company will reverse all of their payments on those claims so far - collecting back all of the money they have already given your medical provider. Then the provider will bill workers compensation and collect from them. Workers comp doesn't actually give payment to your insurance company.
You absolutely cannot continue to put these claims on your health insurance now that you know workers compensation has approved the claim - it will cause a big gigantic mess the more claims you allow to happen before all these reversals occur.
Your physical therapist will need to get authorization from workers compensation for those PT visits that have been ordered for you - if you don't tell them work comp is involved and they don't follow the proper authorization procedures, that could potentially delay your getting treatment.
Not telling your medical providers ASAP could cause a big gigantic mess - causing delays in your treatment and/or leaving you on the hook for some of the bills. Do not delay telling!
2007-09-18 14:49:19 · answer #1 · answered by sarah314 6 · 1⤊ 0⤋
Do tell them it is WC, and explain why you did what you did.
You nade an error in good faith, so let the ins co's fight it out.
When you fell at work, did you tell a supervisor???.
2007-09-18 13:40:54 · answer #2 · answered by TedEx 7 · 0⤊ 0⤋