Disclaimer: This article provides general information about Minnesota workers’ compensation and is not legal advice. For advice specific to your situation, consult an attorney.
Detailed Answer
Under Minnesota workers’ compensation law, your healthcare provider must submit medical bills to your employer’s insurer. The insurer reviews those bills, issues payments to your provider, and sends you an Explanation of Benefits (EOB) showing how much was paid.
1. Review Your Explanation of Benefits (EOB)
An EOB details billed charges, allowed amounts, payments made by workers’ compensation, and any patient responsibility. Look for line items labeled “Compensation Payment” or “Provider Payment.” If you haven’t received an EOB, request one from your insurer or provider.
2. Contact the Insurer or Adjuster
Call your workers’ compensation insurer or claims adjuster. Provide your claim number and provider information. Ask for a payment summary or statement of medical payments. Minnesota law requires insurers to respond promptly to information requests (Minn. Stat. § 176.081).
3. Check with Your Healthcare Provider
Your medical office tracks payments applied to your account. Request an itemized statement showing all payments received and any outstanding balances. This confirms whether payments were applied correctly.
4. Use the Insurer’s Online Portal
Many insurers offer secure online portals where you can view claim details, payment history, and download EOBs. Log in using your claim credentials to check payment status.
5. File a Dispute if Necessary
If payments are missing or incorrect, you can file a medical fee dispute with the Minnesota Department of Labor and Industry under Minn. Stat. § 176.101. For overpayments, you may request a credit or refund under Minn. Stat. § 176.231.
Helpful Hints
- Organize all bills, EOBs, and insurer correspondence by date.
- Keep a log of claim numbers, adjuster names, and contact details.
- Note deadlines for disputes (usually within 90 days of the EOB date).
- Request written confirmation for every payment inquiry.
- Consult a workers’ compensation attorney if you encounter denials or delays.