- You may go to your regular health care provider, an urgent-care clinic, or a hospital emergency room, depending on the extent of your injury.
- Let the medical provider know it is an on-the-job injury.
- Remember, if the claim is ultimately denied, you and your health insurer will be responsible for the bills.
When your claim is accepted
The insurer will pay for:
Keep receipts for all out-of-pocket expenses. Send a written request for reimbursement with proof of expenses to the insurer within two years of incurring the expenses.
You have a right to privacy at medical exams. Your employer or insurer cannot send a representative to your exams without your written consent.
If your claim is enrolled in an MCO
You must choose a doctor from the MCO panel, with some exceptions. For example, you may be able to continue to see a provider with whom you have an established relationship. Call the MCO to help you find a health care provider.
If your claim is denied
If your claim is denied, your health care provider is entitled to send you a copy of the bills.
If you appeal your denial, the provider may make no further attempt to collect payment from you until all your appeals are completed or you settle the claim.
If you do not appeal your denial then your health care provider can bill you.
If you have health insurance, the health care provider must bill your health insurer.