Detailed Answer
When you receive medical treatment under a New York workers’ compensation claim, your provider bills the insurer directly. To confirm those payments applied to your medical bills, follow these steps:
- Request an Itemized Billing Statement
You can ask your medical provider for an itemized statement of services rendered. This document shows each procedure, its charge, and any payment received from your workers’ compensation insurer. - Review the Explanation of Benefits (EOB)
Your insurer issues an EOB after each payment. It details what was billed, what the insurer paid, and any remaining balance. Compare the EOB to your provider’s statement to ensure they match. - Contact the Medical Provider’s Billing Department
If a bill shows an outstanding balance, call the provider’s billing office. Ask whether they received payment from the workers’ compensation carrier. Get a confirmation in writing or by email for your records. - Contact the Workers’ Compensation Insurer
Call your employer’s workers’ compensation carrier to verify payment dates and amounts. Have your claim number and provider details ready. You can also request a copy of the insurer’s payment ledger. - File a Request with the New York Workers’ Compensation Board
If you hit a roadblock—such as an insurer refusing to confirm payments—you can file a C-3 Request for Board Intervention. Under N.Y. Workers’ Compensation Law §23, the Board can order the insurer to provide records and correct any payment errors.
Relevant statutes:
- Workers’ Compensation Law §13 – Employers must furnish and pay for all reasonable and necessary medical treatment.
- Workers’ Compensation Law §13-a – Establishes the statewide medical fee schedule.
- Workers’ Compensation Law §23 – Authorizes penalties and Board intervention for failure to pay timely.
Disclaimer: This article is for educational purposes only and does not constitute legal advice.
Helpful Hints
- Keep copies of all bills, EOBs, and correspondence.
- Note dates, names, and reference numbers in every call.
- Set calendar reminders to follow up with providers and insurers.
- Consider consulting a workers’ compensation attorney if disputes persist.