Q: My employer's insurance company said I did not have to see one of their doctors after my injury is that normal?
My employer uses a third-party insurance company name Sedgwick. Sedgwick stated I did not have to see one of their doctors after I reported my on the job injury.
A:
No, that does not sound right. If Sedgwick is going to pay the bill, they are going to chose the doctor. If you see your own doctor, it is unlikely that Sedgwick will pay the bill. In order for the visit or treatment to be covered, it has to be authorized in advance by Sedgwick. If the visit is not authorized in advance by Sedgwick, your doctor will submit the bill to your health insurer and you will have to pay co-pays/deductibles, or they will bill you directly if you do not have health insurance. Sedgwick can certainly authorize a doctor you chose, but that is not how it is usually done.
Sedgwick may have been telling you that you can see whoever you want as long as you pay for it. They almost certainly would not allow you to chose your own doctor if the claim is accepted and they are paying for the treatment. It is also possible that they do not have a network provider in your area, but I think that is highly unlikely because they would send you to the nearest provider even if that required some travel to another town or city.
I would call Sedgwick back to clarify. Do not rely on Sedgwick to reimburse you for treatment. Instead, make sure they are going to authorize the doctor you chose before you go and if not, have them tell you where to go that is authorized by them in advance.
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