Seeing A Doctor
In order to receive compensation for your Medical Bills is it imperative that you go to one of the physicians that are posted by your employer. There are three types of methods that can be used for your physician referral:
- The panel of physicians method: This method must contain a minimum of six qualified physicians that you may go to and the panel must include four qualified physicians, one orthopedic surgeon and a minority physician.
- The conformed panel method: This must include a minimum of 10 qualified physicians.
- The workers’ compensation managed care organization (WC/MCO) method: This offers a choice of treating physicians from many disciplines and this is a much larger choice of physicians.
If you are not satisfied with your first selection, then you may make only one change to another physician from the list, and that, change of physician will require concurrence of your employer and/or the workers’ compensation administrator. It is important to note that if you decide to go to a physician that is not on the list, then this is considered unauthorized treatment and your employer will not be responsible for any cost of this medical care.
Furthermore, most health insurance companies will not pay for medical treatment for an injury or illness that was on the job. Therefore, it is imperative that you seek treatment from the approved list of physicians as set forth herein above.
There is one exception to this rule and that is if you are in an emergency on the job. At the time that your injury or illness is considered an emergency, then you may receive temporary care at the nearest available emergency location. When your injury or illness is no longer considered an emergency, however, then you must continue your medical care from a doctor that you select on the list as further set forth herein above.
If you need surgery, then prior to scheduling any surgery for an injury that was on the job, except in the case of an emergency, then your physician will notify your employer or your workers’ compensation provider and they will make sure the necessary arrangements are made for your surgery. If you need a CT or MRI Scan, then your physician will arrange for said tests. If you need physical therapy, then your physician will refer you to a provider of physical therapy services.
So long as you use an authorized physician as set forth herein, you will not be responsible for any portion of the cost of your medical care for your injury on the job as all medical bills are paid in accordance with the Georgia Workers’ Compensation Fee Schedule. It is important to note, however, that if your physician charges you above the fee schedule that you should contact your employer or workers’ compensation provider so that these charges are reduced to the fee schedule and corrected so that you are not inadvertently held responsible for any portion above the fee schedule.
Prescription drugs that your physician prescribes are also covered, but it is important to check with your employer or workers’ compensation administrator to make sure that you follow any specific procedure that they have in place for obtaining prescription drugs. In the event that no specific arrangements have been made, then you might have to pay for the prescription and then seek reimbursement from your employer.
You are also entitled to be reimbursed for expenses that you have incurred in order to receive your medical treatment including, but not limited to, mileage, lodging and meals. It is important that you check with your attorney or other workers’ compensation professionals before incurring these expenses, however, so that you are sure that you can be reimbursed for the same.
It is required by law, that expenses that are approved will be reimbursed within 15 days of your submission of proof of said expenses. If you are not reimbursed within 15 days, then penalties will be added in addition to the reimbursement amounts that are properly documented and received. If you fail to submit your approved expenses within one year from the date of service, then you will have effectively waived your right to reimbursement so it is very important that you keep good documentation of your expenses and timely submit said expenses.
If you have any questions about medical bills and medical bill reimbursement, then please do not hesitate to contact us at 770-865-8654, by email at juliericelaw@icloud.com or through our contact form on our website. We are here to assist you and we look forward to hearing from you soon.