Medical Bills You Received That Should Be Paid By The Insurer

Dollar signsThis post explains why you sometimes receive medical bills for care related to your workers’ compensation claim, and what you should do about it.

As you know, one of the main benefits in Maryland workers’ compensation is the payment of any medical bills related to your on the job injury. So if you get a bill, you may be a little freaked out. Usually, there is no reason to be. It is annoying and requires a bit of work on our part, but ultimately this is harmless and will not affect your wallet or your credit.

The law in Maryland is very clear – you cannot be made to pay for medical care that is related to a valid workers’ compensation claim. But the doctor’s offices usually don’t understand that. They believe the patient is always responsible for payment if the insurer doesn’t pay. They will tell you that over and over again.

While technically this is right, the fact is that IF the care is related to your accident, the insurer WILL pay and therefore you will NOT pay. The insurer may be late in paying, or they may try to evade their responsibility for payment by denying your care, but as long as your care is related to your accident, we can force them to pay if we need to.

We can always force them to pay by filing for a hearing and getting an Order from the Maryland Workers’ Compensation Commission. That may cause a delay while we wait for the hearing date, but it will work. We will literally get a Court Order forcing the insurance company to pay the bill.

Sometimes, there is no real problem with the bill and you are only getting a copy of what was already sent to the insurer. They should not do this. It is a waste of paper. But many do. Look at the bill closely. Does it say that it billed an insurer? Does it say “pending insurance payment” on it? If so, you are just getting a second copy and you can ignore it.

The only time you should get worried is if the bill says “second notice” or it threatens to send you to collections. If that happens, call us and get us a copy of the bill immediately. I have a letter I send that resolves 90% of these problems. 

Here is what you should do when you receive one of these bills:

  • Send us any bills you get. We will send your doctor a letter and copy the workers’ compensation insurer. This usually resolves the matter in 90% of the cases.
  • Make sure your doctor has your private health insurance as backup insurance. We will seek to force the workers’ compensation insurer to pay. If the Maryland Workers’ Compensation Commission denies that request, then your private health insurance MUST pay the bill. So make sure the doctor knows they need to keep the private health insurance on file as a backup. They will get paid by one or the other insurance company. We may need a hearing to figure out which one will pay. But they cannot get the money from you. Feel free to show them this post and have them call me if they have questions.
  • If they still keep sending bills, or threaten to send you to collections, notify me immediately. Also call the doctor and tell them the situation. I have never had anyone’s workers’ compensation bills result in a collections charge on their credit. That can only happen if you don’t let us know about this, and we don’t get a chance to intervene. I never want that to happen. If you get a bill, let us know and we will take care of it.

As always, feel free to call me if you have any questions after reading this post. 

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About Tucker Clagett

Tucker has one of the largest Personal Injury and Workers’ Compensation practices in Southern Maryland. He is an experienced litigator, winning jury trials in courts around the state, and successfully litigating appeals in Maryland’s Appellate Courts. Tucker is very active in the community and loves to serve through various community groups and non-profit agencies, some of which he created. He is on the Board of Directors of Living Water of Charles County, which puts water and septic into homes of families with out. Tucker is also a member of the Mason Springs Conservancy, which purchased an environmentally sensitive piece of land along the Mattawoman Creek to protect it from pollution while leaving it open to local fisherman who have been fishing there for decades. Tucker is a member of the Maryland Association for Justice. He served as Law Clerk to the Honorable Richard H. Sothoron on the Prince George’s County Circuit Court.