Legal Question in Workers Comp in Pennsylvania

The short answer is yes. However, the medical provider should bill your health insurance carrier first as they must pay all bills denied by workers compensation. Please call my office to discuss the filing of a claim petition to obtain benefits on your behalf.

If the case has been denied in its entirety via NCD, then the Doctor may send a bill. If any part of the case had been accepted and the reasonableness or work-relatedness is at issue, then the matter should be sent out for utilization review (by Carrier or Claimant) and the answer is, "No." I base this latter point on the Stark II amendments which prohibit direct billing of injured workers. The mecial provider has no standing to bring the UR action herself.

Good Luck.

TV