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Understanding how medical expenses are paid after a work injury

On Behalf of | Sep 6, 2017 | Workers' Compensation

Louisiana workers who suffer workplace injuries or illnesses might have questions and concerns as to how the medical expenses will be covered through workers’ compensation. There are certain facts that people need to know as they are receiving medical care for their issues. Some are important to the worker in the initial stages. Others are more in-depth and are related to forms that must be filled out before payments are made.

The employee can choose one doctor of choice in every specialized field to treat the work-related injury. The employer or workers’ compensation insurer must pay for approved expenses to treat the person as well as travel to get treatment. These will be paid within 30 days of the employer or the insurer getting written notification or within 60 days if the provider does not use electric billing rules and regulations under the law. There must be an itemized list of medical costs that come out of pocket as well as receipts for what the employee paid so he or she can be reimbursed.

If there are medical services for problems that are not emergencies and they cost more than $750 or there is a hospitalization for a non-emergency, this must be pre-approved. A health care provider who seeks to go beyond the $750 limit is required to submit a request for authorization. There must also be medical documentation as to its necessity. The employer or insurer will either approve, deny or approve with modification and return the form. If there is no action by the employer or the insurer within five business days, it will be viewed as a denial. The Office of Workers’ Compensation Administration (OWCA) medical director will review the denial.

There are other forms that the employer or insurer must file regarding documentation for payment for the medical services, but these are technical matters that are beyond the concerns of the injured worker. A worker who suffers an injury on the job should be focused on getting back to full health. Being concerned about factors that should be handled by the employer or the insurer can hinder that goal. When there are worries about workers’ compensation, contacting an attorney can help in dealing with the situation.

Source: laworks.net, “7. How Are Medical Benefits Paid?,” accessed on Sept. 4, 2017


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