Even if you have an allowed OhioBWC claim, there are rules relating to the payment of medical bills.
The first step, in some instances, is having your Physician of Record request authorization for services. This is done through the utilization of a C-9 Request for Authorization Form. Once the request is authorized, the medical bill must be filed wihing 2 years from the date of service. If it is filed after the 2 year deadline, the bill will not be paid even if the procedure was approved and related to your allowed claim condition.
The bottom line: an Injured Worker should periodically check with his/her medical providers to make sure their medical bills are paid.
Additionally, according to OhioBWC rules, if your medical provider is OhioBWC Certified and has accepted payment from the BWC for your medical care, the provider cannot pursue you for any money billed over the amount paid by the BWC. In other words, the provider cannot chase an injured worker for payment in excess of the BWC UCR (usual and customary fee).
Ohio Administrative Code Section 4123-3-23 sets forth the Limitations on the filing of fee bills and payments by the OhioBWC:
Fee bills requesting payment for medical or other services rendered in a claim shall be filed with the bureau or commission within two years of the date on which the service was rendered or shall be forever barred. In cases where the claim was disallowed and by later action is allowed, such fee bills shall be filed within six months from the date of the mailing of the final order allowing the claim or be forever barred. Thus, a fee bill to be timely filed, must be filed either within two years from the date services were rendered or within six months from the date of the mailing of the final order of allowance of claim, whichever period of time is longer, or be forever barred.
If you are the victim of an Ohio Work Injury, call a Board Certified Ohio Workers’ Compensation Specialist Attorney to represent you. Protect yourself and your family.
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