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Disability Law

: Georgia Workers Compensation blog

Can a Hospital Bill Me Directly for Workers' Comp Related Treatment?

By Jodi Ginsberg

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This morning I received a bill in my name for payment due. I called the establishment to inform them that this is a Worknman"s Comp claim and the employee there told me that it has not been filed with Workman's Comp Insurance Company . I relayed this information to our office with a fax number for the paperwork to be sent to the company expecting their money. What else can I do to have this matter resolved? The company I work for is in the process of being closed and I want to make sure this bill is paid.
–Alice

Jodi Ginsberg responds: Alice, thank you for your email. Many times medical offices/hospitals will send bills to patients when it is a workers compensation injury. The law in Georgia prohibits them from collecting money from you when the medical provider is authorized under workers comp. In your case, you indicated that your employer or the workers comp insurer directed you to go to the local hospital. If this is the case then the hospital visit is "authorized" for workers' compensation purposes and the workers' comp. insurer is required to pay the bill.

You should first make sure you put in writing and keep a copy for yourself the fact this is a workers comp case; name and address of employer and workers comp insurance company with your name and date of service etc. Send that info to the hospital with a letter telling them to file it under workers comp. As well, send a copy of the bill to the employer and workers comp ins co and tell them to pay the bill. Keep a copy to the letter you send them as well. This should take care of it. If not, you may need to get an attorney to ask for a hearing.

Also be aware that workers comp pays on a reduced fee schedule in Georgia. This means that the hospital will get paid a set amount for services rendered and this set amount will likely be less than they might bill a non-workers' comp. patient. Any balance remaining over the reduced fee schedule is NOT your responsibility and you should not be sent any bills for the differential owed. If you get billed for the differential, tell the hospital this is workers comp and you are not paying it and do not have to by law.

It is important that you are proactive and assert your rights. If your account is not coded as a workers' comp account, you may find that your credit is damaged even if the charges are eventually paid by the workers' compensation carrier. Don't let this happen - be firm and insist on fair treatment.

Finally, you note your company is going out of business. Do not worry. Despite the fact they are closing, as long as there is workers comp insurance you have a claim with the carrier regardless of whether the employer is or is not open for business.

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