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Care Transfer
#11
(12-13-2016, 05:42 PM)California_Help Wrote: I think you should make sure your private insurance would allow it first.

I also think the CA work comp system is a horrible place to obtain medical treatment, and no guarantees you will get medical treatment requested by your doctor with the UR and IMR system.

Do you have an attorney to discuss this with because no one can give you legal advice other than a lawyer? What you received from your doctor is his opinion and I am sure he has one after dealing with the WC system. What you are getting from this forum is just someone's opinion as well. I think it is a good idea to get completely out of this system with a C&R, however make sure your private insurance will treat these injuries.

There are a lot of people from California posting their problems with receiving medical treatment after they signed a stip and kept their medical open and are continually subjected to UR and IMR denials.



This was a bizarre visit to say the least . Looks like a Workers Comp Mill to me . I need to get out of this god forsaken system or just jump off a bridge. But I can't get covered.
 
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#12
(12-13-2016, 02:47 PM)Shadow Wrote: Ca claim

Ok .. just came home from the PM Consultation. The doctor here said I should C and R my case and shift everything in to my private health insurances.

Not sure why the Doc is giving legal advice.

What are your thoughts on that ?
maybe his payments will be higher?
he can,t speak for your health carrier.
health carriers change; if one might, the others might not.
how can anyone make a blanket statement about a settlement in which both parties have to agree--(it's not up to only you)

attys fees are higher for a c&R and most will recommend it.
no one knows whether one will be offered or the amount.
no thought behind the statement.

what might be more helpful is if your heath insurer will agree to pickup up treatment on care denied by comp.
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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#13
(12-13-2016, 08:50 PM)1171 Wrote:
(12-13-2016, 02:47 PM)Shadow Wrote: Ca claim

Ok .. just came home from the PM Consultation. The doctor here said I should C and R my case and shift everything in to my private health insurances.

Not sure why the Doc is giving legal advice.

What are your thoughts on that ?
maybe his payments will be higher?
he can,t speak for your health carrier.
health carriers change; if one might, the others might not.
how can anyone make a blanket statement about a settlement in which both parties have to agree--(it's not up to only you)

attys fees are higher for a c&R and most will recommend it.
no one knows whether one will be offered or the amount.
no thought behind the statement.

what might be more helpful is if your heath insurer will agree to pickup up treatment on care denied by comp.


I need a doctor that is an intellectual. It appears that they are so freaked out by The DA over pain meds ... the thing is I didn't ask for them . Not everyone is a junkie .

Third world health care .. what a joke. C and R your case , shift everything in to your private insurance ..sure you gonna come see me in Pelican Bay ?

Maybe they should train their MPN doctors a little better ?

SMH !!
 
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#14
there's no training.
just a contract; like you signing up for a rewards card at a store.
doctoring is a business just like lawyering
as joe pesci says: "it's about the dollars; always the dollars."
they may try to get conscientious doctors but MPNs need widest possible coverage area and there may be few choices.
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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#15
(12-13-2016, 09:55 PM)1171 Wrote: there's no training.
just a contract; like you signing up for a rewards card at a store.
doctoring is a business just like lawyering
as joe pesci says: "it's about the dollars; always the dollars."
they may try to get conscientious doctors but MPNs need widest possible coverage area and there may be few choices.

Are private insures eating what should have been workers comp by deception ?

Love Joe Pesci by the way , just am amazing actor.

Thanks folks ..It's a crazy world out there .
 
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#16
without a doubt.
the real rip off was medi-care. they paid billions on insurance cases that settled.
they finally wised up and now they require comp carriers to notify them of all comp claims. if you don't get pre-approval from Medicare before you settle a large claim, they can take credit for the entire C&R amount before they will pay.
it's an administrative nightmare for both them and comp but with the cost of med getting so high they thought it was worth it
with so many different coverages out there, cost shifting is the major scam out there.
that is one of the selling points of a single payer system--little incentive for shifting or duplicate pays.
be well
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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#17
If you do not like your new doctor you can ask for a link to your mpn and change.

It looks like with The Affordable Care Act private insurers are taking injured workers. I would double check your insurance company to make sure.
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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