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How Are Medical Bills Paid through Workers’ Compensation?

June 27, 2022

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Workers’ compensation is an important safety net for workers who get hurt on the job and can’t earn the paychecks they and their loved ones depend on. However, lost wages are only part of the financial hit that temporarily or permanently disabled workers face. They also must deal with big medical bills that can keep piling up month after month, even year after year.

Thankfully, the Ohio Bureau of Workers’ Compensation (BWC) also covers injured workers’ medical bills as long as their injuries occurred at work or while performing activities within the scope of their employment. Although workers’ compensation pays for medical treatments, many injured workers are unsure of how it works, who to submit their medical bills to, or how to get reimbursed if they’ve already paid out of pocket or through their health insurance.

If you have questions about getting approved for workers’ compensation to help pay for your medical bills, keep reading this blog and reach out to our experienced Ohio workers’ compensation lawyers.

The BWC Works with a Managed Care Organization to Handle Medical Bills

Although the BWC foots the bill for injured workers’ medical bills, it doesn’t handle the billing review process itself. Instead, the BWC sends all medical bills to a managed care organization (MCO). The MCO will then review the bill, receive payment from the BWC, and finally pay the hospital, doctor’s office, or other healthcare facility on the injured worker’s behalf.

Be Sure to Notify All Healthcare Providers That Your Injury is Work-Related

To ensure that your medical bills are handled by the MCO and paid by the BWC, it’s important to tell the billing department at your doctor’s office or specialist’s clinic your workers’ compensation claim number and that your injuries happened at work or are work-related. By being upfront with this information, the billing department will know where to send your medical bills to ensure they’re paid on time.

In addition, it also means that bills shouldn’t come to you. Instead, they will be directed to the BWC first, who will then forward them to the MCO.

Out-of-Pocket and Health Insurance Payments Can Be Reimbursed After Claim Approval

It’s common for injured workers to need to pay for some of their treatments out of pocket or through their health insurance policies while they wait for their workers’ compensation claims to be processed and approved. When this happens, they can be reimbursed for any out-of-pocket medical expenses they’ve paid, including co-payments, and their health insurance providers will also request reimbursement for any treatments they’ve covered.

You Can Choose Your Doctor and Pharmacy as Long as They’re BWC-Certified

You may have heard that your employer or the BWC will assign you a doctor that you must see for your treatments after a work-related injury. Thankfully, this isn’t true, and you can choose your own doctor for your treatments.

However, the doctor must be approved by the BWC. This is also true for any pharmacies you wish to use to fill your injury-related prescriptions. The BWC has a provider database that lets you search for BWC-approved physicians and specialists in your area as well as a pharmacy database for pharmacies that are BWC-approved.

Thankfully, emergency room visits immediately after work-related injuries or during the recovery process are typically covered, even if the hospitals or physicians who provide care aren’t BWC-certified.

What Care Is Covered by the BWC?

The BWC covers almost all medical care that injured workers need after on-the-job accidents and injuries. In fact, medical care is covered even if injured workers are only briefly out of work or don’t miss any time on the job, period.

Commonly covered expenses include:

  • Office visits
  • Overnight stays in the hospital
  • Diagnostic tests, including blood work, X-rays, MRIs, and more
  • Surgical procedures
  • Prescription medications
  • Physical therapy
  • Physical rehabilitation
  • Travel expenses for medical procedures and treatments

Let Us Help You Get the Financial Assistance You’re Owed

Unfortunately, getting approved for workers’ compensation benefits in the first place is no guarantee for injured workers, especially when they go it alone. And in many cases, approved workers may face obstacles when it comes to ensuring their replacement income and medical bills are paid in full and handled correctly.

At Nurenberg, Paris, Heller & McCarthy, we have decades of experience assisting injured workers in Ohio. We know how important it is for you to get your medical bills paid in full after a work injury. Contact our Ohio workers’ compensation lawyers today for a free consultation.

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