How do I get delayed medical bills paid by the Workers Comp insurance company? Fighting the Delay: Mediation Secures Payment for Long-Overdue Medical Bill

Navigating the workers’ compensation system can feel overwhelming for injured workers, especially when medical bills go unpaid for months and even years. One of our recent cases involved just that, a client whose authorized treatment from two years ago had still not been paid by the workers’ compensation insurance company. Despite clear paperwork and proper procedures, the bill was still not paid until we initiated Mediation, prompting the insurer to agree to pay within the next two weeks or face the longer legal process of formal mediation.

Doug Landau & experienced Fredericksburg area workers comp lawyer Joel Young agree that workers comp insurance company delays in paying medical bills is a growing problem in Virginia. The Virginia Workers Compensation Commission’s FREE Mediation services help ameliorate this problem.

The issue wasn’t a lack of medical necessity or approval. In fact, the medical provider had submitted everything by the book, using what’s called a Health Care Financing Administration form (HCFA form), which is the industry-standard billing document used for health insurance claims. Along with this form, the provider included CPT codes, short for Current Procedural Terminology codes, which are used to efficiently identify exactly what treatment or procedure was given. They help to explain what service was provided for what injury and why.

So what caused the delay? In many cases, insurance companies rely on third-party companies to handle certain tasks like billing and medical treatment coordination. In this case, companies like “Conduent” and “Apricus” were involved. This type of “outsourcing” can often lead to breakdowns in communications and more issues, where the patients are often left in the dark and not receiving the payments they should be getting.

Over time, our client’s outstanding bill became more than just a small administrative mistake, but potentially impacting their credit and affecting their peace of mind. While we know that insurance delays are sometimes unintentional, even small holdups can have big consequences and effects on injured workers trying to recover, stay on top of their bills and move forward.

Shown here after another successful presentation to the judges, lawyers, TPAs and staff at the Richmond Convention Center, Doug Landau has noted that comp insurance companies are trying to save money by delaying and denying necessary medical treatment for injured workers. Lawyer Landau was again at the podium during the Virginia Workers Compensation Commission’s annual Education Program.

So, what did the workers comp team at ABRAMS LANDAU do? We took action by initiating a request for FREE Mediation through the Virginia Workers Compensation Commission. Mediation is a legal process where both sides meet with a neutral third party, such as a judge, to try to resolve the dispute before it escalates even further. The VWC provides this free service in order to keep cases from going to trial, costly and time-consuming appeals and leading to injured workers falling behind on their bills and becoming displaced. Thankfully, once brought to the table, the insurance side agreed to issue payment within two weeks.

If you or someone you care about is facing unpaid medical bills or complications in the workers’ compensation process, don’t wait. Lawyer Doug Landau and the “Go to” workers compensation team at ABRAMS LANDAU, Ltd. are committed to advocating for those injured while working, and ensuring they receive the timely care and compensation they need. Contact us today to get experienced legal help in for your injury case via e-mail or by calling 703-796-9555.