North Carolina IC Adopts New Medical Provider Fee Dispute Resolution Procedure


Raleigh, NC ( - The N.C. Industrial Commission has adopted a new Medical Provider Fee Dispute Resolution Procedure, pursuant to N.C. Gen. Stat. §97-26(i).

Some highlights of the Medical Provider Fee Dispute Resolution Procedure:

A Medical Provider may submit an Industrial Commission Form 26I: Medical Provider Dispute Resolution Questionnaire directly to the employer or carrier believed to be liable for unpaid medical fees.

a. The Medical Provider will be responsible for obtaining directly from the injured employee information regarding the identity of the employer liable for the injury.

b. The Medical Provider may obtain contact information for an employer, or for the workers' compensation insurance carrier for a particular employer on a particular injury date, by means of the Workers' Compensation Name Search System on the Industrial Commission website.

c. If the Medical Provider is unable to obtain the necessary employer or carrier contact information through the Workers' Compensation Name Search System, the Medical Provider may contact the Medical Fees

Section of the Industrial Commission for assistance in obtaining that carrier contact information.

i. The assistance provided by the Medical Fees Section will be limited to providing employer contact information and to assisting the Medical Provider in identifying the workers' compensation insurance carrier associated with a particular employer on a particular date.

ii. The Medical Fees Section will not share with the Medical Provider any information related to any specific claim before the Industrial Commission.

iii. The Medical Fees Section will not directly facilitate or otherwise be involved in any communication between the Medical Provider and any employer or workers' compensation insurance carrier at this stage in the process. 

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