Getting a medical bill after a workplace injury can be confusing, especially if you already filed a workers’ compensation claim. The bill may have been sent to you instead of the party responsible for handling your work-related medical expenses.
Before paying it, check your claim information and find out where the bill should go.
Make sure the provider has your claim information
Under California Labor Code Section 3751(b), a medical provider cannot collect payment directly from you for treatment of your work injury if you filed a workers’ compensation claim form and the provider knows the claim is pending.
Give the doctor, hospital or clinic:
- Your workers’ compensation claim number
- The claims administrator’s contact information
- Any other claim information the provider requests
This information helps the provider identify your workers’ compensation claim and send the bill to the correct claims administrator instead of billing you directly.
You can also send a copy of the bill to the claims administrator and keep one for your records.
Keep records if the billing continues
If the provider keeps sending bills or collection notices, keep copies of the notices and any emails or letters you send. You can also note the dates of phone calls and who you spoke with.
Workers’ compensation generally covers medical care needed to treat your work injury and reduce its effects. The claims administrator handles payment for covered treatment.
Know when direct billing may be allowed
The protection against direct billing is not unlimited. If the provider receives written notice that your employer rejected liability for the claim and gives you a copy of that notice, the provider may then seek payment from you.
When a medical bill signals a claim problem
A medical bill may point to more than an administrative error. In some cases, it can show that there is a dispute over whether your employer accepts responsibility for the injury or treatment.
If you cannot determine why the provider is billing you, legal guidance can help clarify the problem. An attorney can review claim notices and billing records to determine what is causing the dispute and explain how California workers’ compensation rules apply.