Insurance Help for bills denied under Workers Comp…?
My husband was injured on the job. His boss noticed that he was favoring his injury (Right Shoulder). The bosses daughter took a look at my husbands shoulder and suggested a visit to the Chiropractor (suspected a pinced nerve). The chiropractor saw my husband for free. My husband was referred to an Orthopedic Doctor. I gave my insurance information, but the doctors office requested the Workers Comp case number to file the claim with. I contacted my husbands employer and was told there was no claim; they denied knowing that he had injuries. We soon received a bill for the visits to the Chiropractors office. I filed a workers comp. claim through the Dept. of Labor. The case was denied. Will my insurance company pay the bills since he had coverage at the time of the injury??? They paid the bills initially but back the payment out because of the workers comp coding. Does anyone know if I can resubmit these bills???
If you provide the Workers Comp denial to your health insurance, they may be able to adjust your claims. If not, they may require that the chiropractor re-code the claims to remove the Workers Comp info and resubmit.
Wait a second, the boss noticing he’s favoring his shoulder does NOT make this workers comp. There has to be an injury or “incident” at work, in order for it to be workers comp.
Was the case denied, as to “not being work related”? That’s my guess.
These bills need to be resubmitted to your health insurance carrier.
OK, I work in the workers comp Medical business. Worker’s Compensation laws are specific to each state. In California, you have to have either filed with your employer or a doctor your injuries. That means you have to let your employer know that due to over use, continuous trauma to your shoulder you have injured yourself OR you have to have seen a Medical or Chiropractic doctor and have told them that your injuries are work related. If your injuries were reported and documented by a chiropractor or a medical doctor, then you have a workers comp case, even if your employer denies everything. I will tell you right now, you have a long road ahead of you, fighting with the insurance carriers. You have to get yourself a workers comp attorney and let them do all the filings and referring you to orthos and chiropractors who except work comp liens.
sr has the right answer here.