There is a great deal of misinformation and confusion related to the treatment of an injured worker. Here are a few bits of key information that a medical provider needs to know to assure that it is treated the way the law envisions:
- Virginia has no set fee schedule for workers’ compensation medical reimbursements.
- Virginia is not a managed care state.
- Virginia does not allow for medical management of the claim by the insurance company, nor by any party other than the treating physician.
- The insurance company cannot limit treatment related to an injury.
- You do not need to be on an approved vendor list generated by the insurance company or its representative.
- A case manager cannot dictate care.
- The medical provider manages treatment of the injured worker.
- A medical provider can refer an injured worker to other parties for care.
- A medical provider can treat a patient without outside interference.
- The treating physician determines appropriate treatment for the injured worker.
- A medical provider can communicate with outside parties relating to the injured workers treatment.
- A medical provider’s rates of charge are presumptively valid, and must be paid in full UNLESS the insurance company can establish legitimate grounds for paying less.
- At MeyerGoergen, we can help! We help providers to gain payments far in excess of what the insurance companies may pay initially. Contact MG Law to find out how!