Introduction to Michigan workers’ comp fee schedule and how to choose a doctor.
Michigan law protects employees hurt on-the-job. It covers all reasonable and necessary medical treatment. This includes ambulance runs, emergency room visits, hospital stays, doctor appointments, medication, physical therapy, injections, durable medical equipment, and surgical procedures. There should never be any copayments or deductibles owed and it is a lifetime benefit. Here is some information about the Michigan workers’ comp fee schedule and how to choose a doctor.
Michigan law regulates charges for medical treatment for an injury on the job. Medical providers get paid fixed amounts based upon the workers’ comp fee schedule in Michigan. This is known as “cost containment” and it is not uncommon to see medical bills get slashed by more than 60%.
All medical charges must be submitted on a proper health insurance claim form such as the CMS 1500 or UB-92 for payment to be made. Patients cannot be balanced billed for the difference between what is paid and what is owed.
Medical payments under workers’ comp were found to be some of the lowest in the Midwest. The fee schedule was found to be the primary reason that costs are so cheap. The pure premium rate for employers in Michigan has declined significantly over the last decade, even though medical costs have risen dramatically across the United States.
Choosing your own doctor
Individuals collecting benefits have the legal right to select their own doctor after 28 days from the start of medical care. The only requirement is that notice be given to the insurance company. This can be done by sending a letter or email with the name and address of the new doctor. Sometimes it is necessary to pick-up medical records and deliver them to the insurance company.
Doctors are stuck with fixed amounts under the Michigan workers’ comp fee schedule. This is a fact regardless of their knowledge, skills, or experience. It does not seem fair, but it allows individuals to pick the best doctor possible. Don’t let the workers’ comp insurance company dictate which medical provider must be used because cost should be the same.
Our experience shows that doctors are sometimes hesitant to accept patients under workers’ comp. They do not want to accept lower payments under the fee schedule or risk a potential dispute. It can take months or even years to force a insurance company to pay medical bills.
A very real concern with the Michigan workers’ comp fee schedule is that patients who need medical care will be sidelined. This is because payment amounts are so very low. Medical providers are still businesses who must justify which patients they can or cannot accept. We recommend speaking with an experienced workers’ comp lawyer if medical bills are not getting paid.
Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (844) 201-9497 for a free consultation today.