Late doctor bill on WC case...

We all have heard about workers filing late claims, but what is the time limit on a doctor billing for WC services??? Our employee was injured on the job last Decemeber with a concussion, and we sent him to the emergency room. I filed the appropriate WC paperwork with the insurance carrier. Yesterday, we received a billing dated June 26th from the emergency room doctor, with "FINAL DEMAND", warning of legal consequences if we did not pay or notify them of our carrier's name.The letter stated that the doctor's bill was separate from the hospital's.

I called the billing company , and they tried to tell me that four previous billings had gone out - I struggled mightily not to tell them that they were lying ! So I informed the billing company of our WC carrier's telephone number, and told them to submit the claim. It still puzzles me WHY the hospital correctly submitted their claim to the WC carrier, and the doctor did not. All the doctor had to do was check with the hospital to ascertain which WC carrier was involved!!



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  • You ask a lot Chari, that would take EFFORT on the Dr.'s part. I have had this happen quite a bit. I just forward them on to the carrier..easier than trying to deal with billing offices.

    I do have a weird one now. Guy had knee surgery d/t WC. Everything was billed to his regular health insurance. He is now getting bills for co-pay on what is left..10-15 bucks. WC will not pay co-pays and says it is not their problem to straighten it out. He does not want to mess with calling the health insurance company and wants me to. .He says "I'll just pay it." Don't know what to do.
  • I am not aware of any timeline for doctor bills, so I would like to know too if someone out there has an answer. I have had this same thing happen, receiving bills several months after the service. I just notify the doctor's office that I keep a record of all bills received and this is the first one I received, and then I forward the bill to the work comp company and let the doctor know it has been forwarded.

    As for the guy whose personal insurance was billed instead of w/c, I would let him know that even though it is a hassle he will have to mess with it. Once his personal insurance (or company health insurance, whatever) finds out that this was a w/c claim, they can come back to him and request to be paid back for the full amount. It will be more work down the line if he does not just get it straightened out now.
  • Having worked in the healthcare industry for many years, I can tell you that wether it's privare or W/C, doctors are notorious for this kind of stuff. If they do not have an office staff that is on the ball, by the time he remembers all the patients that he/she saw in the Er/Hosp it could be months before the services gets billed properly.

    As for the W/C carrier telling you that it's the patients responsibility? well I can tell you if it was in California (Los Angeles to be more exact) you would have an attorney knocking at your door. It sounds like you need to contact an unit manager or your broker and file a complaint regarding the W/C claims adjuster attitude.
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