Ohio Worker's Compensation - Help For Injured Ohio Workers

• Ohio Worker's Compensation - Quick facts about worker's compensation law, benefits and lawyer fees.

• Ohio Worker's Compensation Resources - Links and resources for injured workers.

Page 1 of 3 123 LastLast
Results 1 to 10 of 26

Thread: Unpaid Medical

  1. #1
    Join Date
    Mar 2007
    Posts
    84

    Default Unpaid Medical

    Am just seeking advice on how to go about getting medical bills which are now in collections paid.

    Here we go I was injured back in 1998-99. To date I have thousands and I bean thousands of bills dating back to 1999 which remain unpaid and are now in collections. These bill to say the least have completely destroyed my credit.

    I have faxed every single bill to the MCO and what they tell me is they were submitted with the wrong ICD-9 and or diagnosis code. These treatments and expenses are all related to the allowed conditions of my claim.

    MCO is telling me they will resubmit with instructions to change codes, but they also state that it is my responsibility to call and or tell the billing parties to bill under the correct code. I am not a medical billing expert nor have I worked in this Field so how is one to know this?

    Now on to what I believe is happening between the MCO and BWC. These bills in question (ones MCO state were submitted incorrectly). I think what they do is keep shuffling these bills back and forth for the time in which MCO has to pay until they have reached the 2 year statute of limitations in which the MCO has to pay such expenses.

    I think there should be someway to go after the MCO for not paying expenses related to my claim and diagnosis codes. Maybe under the RICO ACT, Fraud. I would like input from other IW's if they are having the same problems. Since the MCO has not paid the expenses does the MCO and BWC have the right to have in their possession medical records for these unpaid expenses?

    I think this would be a great subject for OIWCO to have on the website as this is another example of how the IW is being financially hurt and screwed.

    The MCO in question is Medical Administrators Inc. Please let me know if anyone has had the same issues with this MCO. Maybe a Class Action suit can be filed.

  2. #2
    Join Date
    Mar 2007
    Location
    Ohio
    Posts
    417

    Default Re: Unpaid Medical

    I have to deal with Aultcomp for a MCO and they try to pull the same shit Dennis. What you have to do is call the original doctors office, talk to the billing department and explain to them what the MCO is pulling, then between the doctors office and the MCO it dhould get straightened out. However, keep a very good record of who you talk to, when(date and time) you talked with them, and what company they are from. This is the only way you will be able to prove to any debt collectors you are trying to get these bills taken care of. This way if a collector calls all you have to say is I talked to soso and soso from that office on friday and they will be resubmitting the bill to BWC with proper ICD-9 codes for payment, thanks for calling. Then if they don't believe you they can check it themselves. If they keep giving you shit after that give them the MCO's number and your caseworkers name and tell them she will be handeling this from now on for you, that will shake it up a bit.

  3. #3
    Join Date
    Mar 2007
    Posts
    84

    Default Re: Unpaid Medical

    jojo,
    I have done all this. The only way out is to file bankruptcy. To me this is a criminal act and i'm not taking this lightly. I have been trying for the better part of seven years to get these bills paid but as usual the IW gets screwed again.

    Now if the IW does not file bankruptcy what is going to happen when you go to settle? are they not going to deduct for such expences. I am amazed others have not responded. I know I am not the only one this is happening to.

    This should be right up there with the unfair IME's as we are being defrauded. Should we all carry a tub of vaseline around with us to make the screwing a little easier.

    I cannot get a loan, am paying higher interest rates on credit cards, have lost posessions and am now financially ruined due to this. I dont remember reading that because I was injured this was going to happen. What can we do???

  4. #4
    Join Date
    Mar 2007
    Location
    Ohio
    Posts
    417

    Default Re: Unpaid Medical

    Where do you live Dennis?

  5. #5
    Join Date
    Feb 2007
    Posts
    775

    Default Re: Unpaid Medical

    Den;

    If I understand your predicament you have unpaid bills becuase the MCO deems those bills related to non-allowed conditions secondary to miscoding. If so this is not an unusual occurrance and one an atty will generally stay on top of, meaning rectifying the coding error via communicating with the provider of those services to get the codes lined up with the allowed conditions or, if justifiable, pursiong amending new conditions to the claim.

    The fact that it is your personal belief that ALL the treatments and bills were related to your injury is, unfortunately, of no significance. The facts as you have stated them are that that is not the case at all from a legal view of the facts. Getting the bills paid is a strictly legal matter.
    You do understand that the MCO does not pay the bills, BWC does, but only for MCO approved treatments. So- how did it happen that you ran up bills not authorized by the MCO so that BWC could pay them ? I think there is waaaay more to this story than is being presented.

    As you are not a coder or a biller nor have any experience or knowledge of the field it is then your attys full responsibility to rectify the situation to the best of his ability. ( I don't remember you mentioning an atty in your various posts....)

    If you have exhausted the appeal process on denied allowances then right or wrong the matter is over. What has your atty done to get you out of this mess ?

  6. #6
    Join Date
    Mar 2007
    Posts
    84

    Default Re: Unpaid Medical

    Quote Quoting jojomfd1 View Post
    Where do you live Dennis?
    Live in the Cleveland area.

  7. #7
    Join Date
    Mar 2007
    Posts
    84

    Default Re: Unpaid Medical

    Quote Quoting POR View Post
    Den;

    If I understand your predicament you have unpaid bills because the MCO deems those bills related to non-allowed conditions secondary to miscoding. If so this is not an unusual occurrence and one an atty will generally stay on top of, meaning rectifying the coding error via communicating with the provider of those services to get the codes lined up with the allowed conditions or, if justifiable, pursuing amending new conditions to the claim.

    The fact that it is your personal belief that ALL the treatments and bills were related to your injury is, unfortunately, of no significance. The facts as you have stated them are that that is not the case at all from a legal view of the facts. Getting the bills paid is a strictly legal matter.
    You do understand that the MCO does not pay the bills, BWC does, but only for MCO approved treatments. So- how did it happen that you ran up bills not authorized by the MCO so that BWC could pay them ? I think there is way more to this story than is being presented.

    As you are not a coder or a biller nor have any experience or knowledge of the field it is then your attys full responsibility to rectify the situation to the best of his ability. ( I don't remember you mentioning an atty in your various posts....)

    If you have exhausted the appeal process on denied allowances then right or wrong the matter is over. What has your atty done to get you out of this mess ?
    POR,
    Bills are all related to the allowed conditions of my claim. Why would you say "The fact that it is your personal belief that ALL the treatments and bills were related to your injury is, unfortunately, of no significance". It is a significant amount of money that is owed.

    As I said before there is a two year statute of limitations on medical bills which means I am responsible for all expenses which is excuse my french BULLSHIT! I will again say it is a paper shuffle. I also have a stack of unpaid expenses for treatments done after my surgeries in the hospital. Why would they (MCO) consider this not related?

    The MCO is in fact responsible for getting such bills paid as all bills are submitted to the MCO. I have faxed copies to both the BWC and MCO and get the same answer every time " we will look into the matter" just a polite way of saying screw you.

    Also all treatments or appointments do not have to be authorized by the MCO. I have been to the ER numerous times, have had many treatments authorized which still remain unpaid. What the MCO is doing is a criminal act and fraudulent.

    I know you say it is my attorney's responsibility but when a bill is submitted with a code that falls into the general area of the allowed condition is it not the MCO's sole responsibility to rectify any billing issues? Is this not what the MCO was hired to do.

    It all boils down to cost cutting which is another reason for the MCO. Personally I think you could care less about the Injured Worker and care more about lining your pockets. Now I ask what happens when I settle and the BWC deducts the unpaid expenses because they now feel these treatments were related to the allowed conditions of my claim????

    What it all boils down to is the IW means nothing to the BWC and MCO and we keep getting screwed as usual.

  8. #8
    Join Date
    Mar 2007
    Location
    Ohio
    Posts
    417

    Default Re: Unpaid Medical

    I was going to give you the number of a good attorney, but he is in canton. That is a long drive from cleveland. sorry

  9. #9
    Join Date
    Mar 2007
    Posts
    84

    Default Re: Unpaid Medical

    jojo,
    Thanks. I do have an attorney in which I am happy with. The problem is that there is a two year statute of limitations. My attorney has sent letters and done everything in his power to remedy the situation.

    The problem is the corresponding between BWC, MCO and attorney. "paperwork shuffle". every time you call the MCO I think they tell you what you want to hear and then all bills go from the top of the stack to the bottom.

    I can't wait to hear what POR has to say about this. If he's never had a problem with billing issues and has always been paid on time all I can say is that if it look like a duck, quacks like a duck it's a duck.

    I just sent another email to the Toledo Blade informing them of our situations and let them know of a protest which could be happening very soon. It does seem that more often than not people are afraid to stand up to the BWC.

    We Injured Workers need to put an end to all of this madness. I have also just read that there are no laws regarding taping of Exams, or at least no one is able to find them. I will find the article and post it.

    Seems the BWC is just above the Law and could care less about their pledge of service to the IW.

  10. #10
    Join Date
    Mar 2007
    Location
    Ohio
    Posts
    417

    Default Re: Unpaid Medical

    Seems the BWC is just above the Law and could care less about their pledge of service to the IW.
    I have been saying the same thing for the past year and a half. Our government is supposed to be set up as a system of checks and balances. Who checks the BWC? Noboby will answer this for me in a truthful way.

Similar Threads

  1. Am I Required to Declare Unpaid Help or Volunteer Work
    By watkins0566 in forum Legal Issues
    Replies: 5
    Last Post: 02-25-2010, 12:16 AM
  2. Unpaid Motel and Meals
    By nascar8de in forum California
    Replies: 13
    Last Post: 08-06-2008, 09:48 PM
  3. Unpaid Leave vs TTD Benefits
    By VALCOOKMEOW in forum Legal Issues
    Replies: 37
    Last Post: 06-24-2008, 05:56 PM
  4. Replies: 5
    Last Post: 01-22-2005, 07:16 AM
  5. Unpaid award
    By anonymous in forum West Virginia
    Replies: 1
    Last Post: 04-29-2003, 12:45 PM

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
 


Find a Lawyer