Detailed Answer
If you’ve received medical treatment under a New Jersey workers’ compensation claim, you have the right to confirm that your insurer paid your medical providers. Start by gathering all itemized medical bills from your doctors, therapists, hospitals, and pharmacies. Next, request an Explanation of Benefits (EOB) or payment history from the workers’ compensation insurer. This document outlines which bills have been approved and the date and amount paid.
Under New Jersey law, insurers must satisfy medical liens and notify providers once they process payments. See N.J.S.A. 34:15-38 for lien requirements and payment procedures: N.J.S.A. 34:15-38. If you don’t see a bill marked as paid, contact the claims adjuster directly. Provide the bill’s date, provider name, and amount due. Ask for a written statement showing payment status. If a provider still reports an outstanding balance, request a lien satisfaction letter or updated EOB.
Common reasons payments may not apply include missing authorization, late bill submission by the provider, or a clerical error. If you discover an unpaid bill through your own review, alert both the insurer and your employer. You may also file a petition with the New Jersey Division of Workers’ Compensation to resolve billing disputes.
Disclaimer: This article provides general information about New Jersey workers’ compensation procedures. It does not constitute legal advice. Consult a licensed attorney for guidance tailored to your situation.
Helpful Hints
- Keep copies of all medical bills and prescriptions in one place.
- Request EOBs after each treatment or billing cycle.
- Follow up in writing—email or certified mail—so you have proof of your inquiries.
- Verify that the claim number and provider information match on each document.
- If you hit an impasse, consider contacting the New Jersey Division of Workers’ Compensation for assistance.