Insurance companies responsibilities:
No later than 30 calendar-days after receiving the charge for service and the medical records, the insurer must:
- Pay the charge or portion of the charge that is not in dispute.
- Request specific additional information to substantiate the nature of the charge and its relationship to the work injury. When the requested information is received, the insurer has 30 days to either pay or deny the charge in question.
- Deny all or part of the charge if it is not compensable.
- Deny all or part of the charge if the charge is excessive.
If the charge is denied, the insurer must send the provider a written notification outlining the basis of the denial by the 30-day deadline. A copy of the notification must be sent to the employee.
Health care provider responsibilities:
The health care provider is responsible for:
- Submitting an itemized statement of charges on the prescribed billing form to the payer within 60 days of the service.
- Submitting copies of medical records or reports that substantiate the nature of the charge and its relationship to the work injury.
A health care provider cannot attempt to collect or initiate any action for collection of the charge from any party until the information required has been furnished.
If the insurer has denied primary liability, the health care provider can bill the employee.
If the employee’s health insurance pays the medical expenses, the insurance company has a right to reimbursement if it is later determined the charges are due to a compensable injury.
The 612 Injured Difference
Being injured is serious. After you have sustained an injury, the world can seem like a scary place. Your boss may be pressuring you or threatening to retaliate. The aching pain makes it hard to operate how you usually do. You do not always know which way to turn, or how to get help.
That is where we step in. 612 Injured has a team of workers compensation attorneys who are second to none. We are with you at every point. Your case is personal to us. We give you big-firm resources that can give you small-firm attention.
When it comes to workers compensation, you will not find a law firm that is as dedicated, reliable, and devoted as we are. Other law firms will treat you like a number. With us, you are not Case #7489. You are you, with your own wants, desires, and needs.
Call us today. The earlier you get started, the easier it will be.
What are independent medical examinations?
The insurer may ask you to be examined by a health care provider of its choice. The examination is often called an independent medical examination (IME), but make no mistake this doctor is working for the insurance company not you! The insurer may suspend your benefits if you refuse to be examined by the doctor. The insurer must reimburse you for mileage and other costs for attending the examination.
UNLESS WE WIN
Our attorneys work on a contingent basis. This means that we will not charge you a fee unless we win either at trial or through settlement.
The percentage we charge will depend on the difficulty of your case, and the amount of time and money we estimate it will take to get you the most recovery for your damages.
OUR COMMITMENT TO
Promptly Addressing Your Needs
Our attorneys and staff will make sure that your concerns are addressed as soon as possible. We know that legal issues can be stressful and anxiety producing. We will do our best to work on your behalf towards a solution.
We aren’t here just to bill hours or cause unneeded disputes. We are here to serve you to get results. At all times we use our expertise and creativity to get the absolute best resolution to your legal issues.
Being Available to Meet You in Person
If you want to speak to your lawyer face-to-face, we have several Twin Cities office locations convenient for you.
Responding to Your Inquiries
Whether by phone, email, text, fax or mail, our team will be available to answer your questions ASAP.
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