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Seeing Personal Dr After Comp Injury: CA - Printable Version

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Seeing Personal Dr After Comp Injury: CA - c_smith - 05-29-2015

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


RE: Seeing Personal Dr After Comp Injury: CA - 1171 - 05-29-2015

(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.


RE: Seeing Personal Dr After Comp Injury: CA - c_smith - 05-29-2015

(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.




RE: Seeing Personal Dr After Comp Injury: CA - California_Help - 05-30-2015

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)