Workers' Compensation: The Application for Fee Review Process
A Workers' Compensation (WC) insurance carrier has 30 days to pay your bill, deny the worker's claim for benefits, or request a utilization review. If your payment is late or incorrect, file for fee review. Incorrect payment would include any "network discounts" the insurance carrier asserts.
Only coordinated care organizations (CCOs) are allowed to apply a discount to the state's WC fee schedule, and there are no registered CCOs in Pennsylvania. Therefore, if an insurer attempts to discount your bill, file for fee review.
Also, it’s not uncommon for insurance carriers to lag behind in annually updating their fee schedules. Make sure you’re receiving your 3.6 percent increase for all services provided as of Jan. 1, 2008.
Publication: Workers' Compensation: The Application for Fee Review Process
This publication from the Pennsylvania Medical Society provides answers to why, when and how to file for a fee review by the Bureau of Workers' Compensation and includes sample proof of service and physician lien forms. State Society members can order a printed copy of Workers' Compensation: The Application for Fee Review Process through our online store or can download the PDF below.
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Last Updated: 5/19/2008