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:
No
- 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.
Yes
- 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!
The materials on this website are meant for informational purposes only and nothing contained in this site is to be construed as legal advice. If you need legal advice, you should contact an attorney directly. Do not act upon the information on this site without seeking professional guidance. Information on this website about specific matters or success in previous cases is not meant to be a prediction or guarantee of similar results in any other case. Each case consists of factors and applicable law unique to that case and you should consult an attorney.
