Q: I was awarded med benefits for my injury that happened at work i have been seeing the same physician that Initially
treated me in the ER I had an outpt surg done that Liberty is refusing to pay stating not an authorized surgery. I thought that if i was awarded med bens no one had to worry about getting auth or approval especially since the treating physician has been working on me since day one. The ER surg was paid for as well as my follow up visits. My adjuster says they never got notification even after telling her i was awarded med bens. Please help!!
UPDATE:
I provided the answer to my Adjuster and she asked for all of my medical records so they could review everything again.
A: This is the procedure. You have an accident. You report it to your employer. The employer reports it to is WC insurance carrier. Then, the insurance company is supposed to send you a panel of three (3) doctors to pick a doctor from. When you pick that doctor, that doctor becomes the "authorized" doctor. Sometimes it does not work that way. In your case, it appears you went to the ER and got treatment at the ER. If the surgery was done by the ER doctor, then you should be OK. You need to contact the Virginia Workers' Compensation Commission 1-877-664-2566 and file a claim to have this paid for. You will need to file the medical treatment papers AND the itemized bills.
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