Detailed Answer
If you want to confirm whether your workers’ compensation insurer applied payments to your medical bills in Virginia, follow these steps:
- Obtain your Explanation of Benefits (EOB). Insurers must send you an EOB for each medical service. It shows billed charges, approved amounts, and payments made.
- Compare billing statements. Gather itemized medical bills from your provider. Match each line item to entries on the EOB. Look for any unpaid balances or adjustments.
- Request records from your insurer. Under Va. Code § 65.2-702 (Medical services and supplies; hospital services; fee schedules) your insurer must maintain records of all payments. You can request a copy in writing. Link: https://law.lis.virginia.gov/vacode/title65.2/chapter7/section65.2-702/
- Contact your adjuster or claims examiner. Call the adjuster listed on your EOB. Ask them to confirm payments and explain any unpaid or adjusted charges.
- Use the Workers’ Compensation Commission portal. The Virginia Workers’ Compensation Commission provides case worksheets and claim information online. Visit https://www.workcomp.virginia.gov/ for free access.
- File a Claim for Payment of Medical Expenses if needed. If you discover unpaid bills, you can file a formal claim under Va. Code § 65.2-602 to compel payment. Link: https://law.lis.virginia.gov/vacode/title65.2/chapter6/section65.2-602/
Helpful Hints
- Keep copies of all medical bills and EOBs in one file.
- Note dates and reference numbers when you contact your insurer.
- Review the Virginia workers’ compensation fee schedule to know standard rates.
- Use certified mail when you send record requests.
- Consult the VWCC self-help section for guides and forms.
Disclaimer: This article is for educational purposes only and does not constitute legal advice. For guidance on your specific situation, consult a qualified attorney or authorized representative.