Gaithersburg: 301-670-7030
Baltimore: 410-769-5400
Frederick: 301-668-2100
Contact Us For Legal Help

Workers' Compensation Blog

Why is it taking so long for my medical bills to be paid?

Wednesday, October 10, 2018

HCFA Forms

Maryland Workers’ Compensation laws require that medical bills be submitted on HCFA forms. These are standard billing forms used by most insurance companies that have fields for the appropriate and necessary CPT (current procedures terminology) codes. However, some practitioners may not be aware that this is a requirement for workers’ compensation claims or that the bill may be denied if it is not submitted properly on the HCFA form. The adherence to this rule varies between insurance companies, however if your provider is having trouble getting bills paid then the first step should be to ensure that the bills are submitted on HCFA forms. As an easy reference the workers’ compensation website provides a blank downloadable HCFA form.

Itemized Billing

Another reason your workers’ compensation medical bills are not getting paid could be that the bill that was sent to the insurance company was not itemized with the proper CPT codes. The workers’ compensation carrier cannot pay bills that are not properly itemized with these specific codes, similar to the codes that a primary care physician would provide to a private insurance company. In addition, many carriers also require that each office visit note from the billed dates of service are provided with the bill. This requirement is to ensure that the visit was related to a compensable body part or condition. Where the system fails is when the carrier denies payment of the medical bills and does not site to the reason it is denied. Often it is a clear case of one department not providing the proper medical records to the carrier’s billing department. Instead of working together the billing department denies the payment of the bill. To resolve this confusion and to save time our firm often will attach the appropriate medical report when sending in any reimbursement or bill pay request even though the carrier may have previously received the report.

Collections Letters

When a medical bill has not been paid, for various reasons, the provider will often send the bill to a collections agency or will seek payment from the claimant. It is important to know that a provider has their own course of action within the workers’ compensation commission to collect on bills for approved medical treatment. This is done through submitting a C51 claim for medical services to the commission. The commission will then issue an order nisi to the carrier requiring payment of the bills. The provider can request penalties, fees and interest if the bill is unpaid for over 45 days and the carrier failed to provide written communication of the denial. In addition, a claimant may notify the collections agency or doctor’s office that under Sec. 9-660, Labor and Employment Article, MD. Ann. Code, medical expenses related to an accepted and related workers’ compensation claim should be directed to the workers’ compensation insurance carrier.

Contact your Attorney

Facilitating payment of medical bills is one of the services we provide to our current and past clients for workers’ compensation cases we have handled. If you have not filed a claim for medical services that you feel are related to a workers’ compensation claim please contact our office as soon as possible so that we may assist you before these bills effect your credit.

Recent Posts


Tags

Coming and Going rule, D.C. attorney National Holidays Workers Compensation and Bankruptcy Vocational Rehabilitation Workers Compensation Fraud Workers’ Comp Attorney Firefighters Auto Accidents Veterans Attorney Allyson Bloom Transportation Reimbursement Workers Compensation for Police Officers Attorney Cliff Sobin Workers Compensation Benefits for Teachers Medicare and Workers Compensation Temporary Total Disability MSPRC Medical MSEA Fire Fighters Prescription Medication Side Effects Police Officers Opioids Workers Compensation Claim Corrections Officers Work Related Injury Liabililty Average Weekly Wage Attorney Gretchen Rogers Disability Insurance Denial Attorney Nicole Lambdin Injured Fire Fighters Auto Injury Incident Report Maryland Workers Compensation Hearing Injured Courier Worker Accident Report Unemployment Benefits workers Compensation Act Attorney Charles Schultz injured railroad workers Death Benefits Workers Compensation win for 911 dispatcher Coming and Going rule Laws and Regulations Maryland Workers Compensation Commissioners Wrongful Death Claim Vocational Rehabilitation Benefits Railroad Injuries Damages Maryland Workers Compensation Procedure auto accident attorney Attorney Matthew Engler Attorney Ken Berman Workers Compensation for Firefighters Attorney Alan Gross Attorney Lauren Pisano Maryland Workers Comp Benefits Claims Process Attorney Matt Darby Independent Medical Evaluation Injured School Bus Drivers FMLA Maryland Workers' Compensation Claim – Is My Injury Covered? Maryland Fire Fighters DC Workers' Compensation Medical Travel Expense Dependent Maryland Lawyer Occupational Hazards Attorney Julie Mirman Criteria attorney Natalie Whittingham Occupational Diseases Permanent Disability Mileage Reimbursement Injury Report Firefighters and Hearing Loss Attorney Ari Laric Physical Training Injuries for Firefighters Personal Injury Teachers

Archive

RSS

What Our Clients Say

Known for our unwavering commitment to clients, for our integrity, and for delivering the best results, our clients continue to refer their friends, families and neighbors to us for their legal needs.


"One year ago today I made the call to your office. The best decision I could make. I wanted to share with you how impressed I am with your staff and your professionalism."

Heather P.


"Craig did a great job representing me! He's the lawyer I have trusted with my legal needs because he's professional, knowledgeable, and keeps me informed about my case."

Jaclyn K.


"I would like to express my gratitude for your efforts and dedication for my disability case. It's has been quite a long and upsetting process but you have handled my case in an extremely competent and responsible manner."

Leo H.


"I have recommended Mr. Feldman to several of my friends and colleagues and have heard nothing but excellent reviews. He is the best lawyer I have ever used."

Martin


"I received the check today. I could not believe it until I saw the check. Thank you so much. You have improved my family's quality of life tenfold."

Mike F.


"These guys go above and beyond! They always have your best interest in mind."

Mike W.


"You have been kind throughout this process and I appreciate your professionalism as well as your gentle concern. Thanks for helping us and all the others who need your legal expertise. We are grateful."

Nancy F.


"Thanks to Mr. Shultz's aggressive and professional work ethic style I was able to receive the medical services and compensation pertaining to my case."

Navdeep C.


"I can honestly say this firm is simply TOP NOTCH! They not only have handled countless cases for my members that require their services, they also have gone well beyond their "scope" to help some of my folks in other areas of need. "

Rick H.


"The attention and professional care the staff has taken toward my needs has always been excellent. I have no complaints nor worries that my issues discussed are not addressed."

Tim T.


"I just got off the phone with Craig and let him know how thankful we are to you, him and Ken for all your efforts – you are all really terrific to work with!"

Val K.


Locations Throughout Maryland, Virginia & Washington DC

Gaithersburg Office

481 N. Frederick Avenue, Suite 300
Gaithersburg, MD 20877
301-670-7030 / 800-248-3352
Fax: 301-670-9492

Lutherville Office

1301 York Road, Suite 600
Lutherville, MD 21093
410-769-5400 / 800-248-3352
Fax: 410-769-9200

Frederick Office

30 W. Patrick Street, Suite 105
Frederick, MD 21701
301-668-2100 / 800-827-2667
Fax: 301-668-2000

Subscribe To Our Newsletter


TOP