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Why Do Medical Providers Bill You When it is a Work Injury?

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By: Kevin Kampschror, Esq.

NRS 616C.135 states in relevant part that a provider of health care who accepts a patient as a referral for the treatment of an industrial injury or an occupational disease may not charge the patient for any treatment related to the industrial injury or occupational disease, but must charge the insurer . . . If a provider of health care, an organization for managed care, an insurer or an employer violates the provisions of this section, the Administrator shall impose an administrative fine of not more than $250 for each violation.

One of the most vital benefits under Nevada workers’ compensation laws is that the injured worker does not have to pay for the medical care, not even a small co-pay. The above law states that when an injured worker is receiving benefits from the Nevada workers’ compensation laws due to an industrial injury, the injured worker pays nothing for the medical care. NRS 616C.135(4) states that the medical provider must not bill the injured worker if the treatment is industrial and the medical provider or insurer could even be fined for each violation.

How do injured workers receive bills and what should they do? Injured workers know whether they have accepted claims because they are sent a letter stating the claim is accepted and for what body part. If the injured worker then gets referred to a doctor because the claim has been accepted, there is no question the treatment is industrial and should not be billed to the injured worker. Despite this, injured workers still receive bills, even are sent to collections that can and will negatively affect their credit. As many are aware, it is a significant inconvenience and hassle to resolve an issue that is in collections, especially to no fault of your own.

Injured workers can contact providers and inform them the bill is for workers’ compensation medical care and to stop billing the injured worker directly. However, this does not always work. Injured workers can also file a complaint with the Division of Industrial Relations that the provider is billing them. However, time is of the essence especially if the bill is in collections damaging your credit. Injured workers need to move quickly!

It is advised you seek an experienced attorney who is able to assist in obtaining all benefits that you are entitled to under Nevada law, which includes assisting in making sure you are not billed directly for services rendered under Nevada workers’ compensation laws.

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