Detailed Answer
This guide explains how to confirm whether your workers’ compensation insurer applied payments to your medical bills under Maryland law.
1. Review Your Explanation of Benefits (EOB)
After your medical provider submits a claim, the insurer issues an Explanation of Benefits (EOB). It details billed charges, paid amounts, and any adjustments. Compare the EOB line items—service dates, provider names, and claim numbers—to your medical statements. If you don’t have an EOB, request one from your insurer or your claims adjuster.
2. Check With Your Medical Provider
Contact the billing department of each medical provider. Ask whether they received payment from your workers’ compensation insurer. Request a billing ledger or itemized statement. That document shows all payments applied, outstanding balances, and write-offs.
3. Use the Maryland Workers’ Compensation Commission Portal
The Maryland Workers’ Compensation Commission (WCC) offers an online portal where you can access claim records, filings, and payment orders. Log in or register at the WCC website, then search by claim number or your name. Review any payment orders under MD Code, Labor & Employment §9-610 (link), which governs compensation payments.
4. Review Commission Orders and Filings
Open all WCC orders and filings related to your claim. Payment breakdowns often appear in hearing orders or settlement agreements. If the insurer missed payments, the WCC may issue a penalty order under MD Code, Labor & Employment §9-690 (link).
5. Consult an Attorney or Accredited Claims Adjuster
If you identify discrepancies, seek help. A workers’ compensation attorney or an accredited claims adjuster can file a request for hearing or a motion to enforce payment. They can also negotiate with the insurer to clear any unpaid medical bills.
Disclaimer: This article provides general information under Maryland law. It does not constitute legal advice. Consult a qualified attorney for guidance on your specific situation.
Helpful Hints
- Keep copies of all EOBs, invoices, and correspondence.
- Note claim numbers, service dates, and provider names.
- Track deadlines: you generally have 30 days to request a hearing after a denial or dispute.
- Send important documents via certified mail or secure email.
- Log each call: record dates, times, and names of representatives.