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Seeing Personal Dr After Comp Injury: CA
#1
I am in California, this is in regards to SCIF.
I have a back claim and I have medical for life. I also have arthritis in my back. It's been a while since I have seen the comp Dr and to see them would take a couple of weeks to get the approval. I am having back issues but I think it's related to the arthritis so I want to go to my personal doctor.
But if it is related to the comp claim I don't want my insurance to charge me for the visit. Is there something I need to do in advance to ensure that doesn't happen?
TIA
 
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#2
(05-29-2015, 05:52 PM)c_smith Wrote: I am in California, this is in regards to SCIF.
I have a back claim and I have medical for life. I also have arthritis in my back. It's been a while since I have seen the comp Dr and to see them would take a couple of weeks to get the approval. I am having back issues but I think it's related to the arthritis so I want to go to my personal doctor.
But if it is related to the comp claim I don't want my insurance to charge me for the visit. Is there something I need to do in advance to ensure that doesn't happen?
TIA

find out if your doctor is in their medical provider network.
http://www.viiad.com/KBSTATECO000
if so advise them in writing that you are switching your treatment.
if your doctor is not in their MPN, then it's unlikely the carrier will approve treatment.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#3
(05-29-2015, 07:22 PM)1171 Wrote:
(05-29-2015, 05:52 PM)c_smith Wrote: I am in California, this is in regards to SCIF.
I have a back claim and I have medical for life. I also have arthritis in my back. It's been a while since I have seen the comp Dr and to see them would take a couple of weeks to get the approval. I am having back issues but I think it's related to the arthritis so I want to go to my personal doctor.
But if it is related to the comp claim I don't want my insurance to charge me for the visit. Is there something I need to do in advance to ensure that doesn't happen?
TIA

find out if your doctor is in their medical provider network.
http://www.viiad.com/KBSTATECO000
if so advise them in writing that you are switching your treatment.
if your doctor is not in their MPN, then it's unlikely the carrier will approve treatment.
Thanks. My doctor isn't in the network.

 
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#4
The only way not to be charged is to see a doctor in your MPN. If you believe this is from your work related injury, I recomend taking the extra time to do things correctly and see a doctor in your MPN. It is a good idea to go and see a doctor for your work related injury at least a few times a year, or the WC insurance carrier can try to close your work comp claim. I have seen this happen to a few injured workers who went a year or so without seeing any doctors in the MPN. This will not happen without notifying you first, and you can appeal it. I just think it is easier to avoid this by seeing a doctor at least once or twice a year in your MPN.(JMO)
I am not an attorney.Anything I write should not be considered legal advice.I am writing from my own personal experiences,which is not from any sort of legal background. You should consult with an attorney over legal issues. In California, if you cannot get an attorney you can consult with an I&A officer.
 
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