Generally, no. Once the claim has been recognized as a WC claim through the issuance of a Notice of Compensation Payable or Judge’s decision, the doctor can’t bill you for treatment of the injury. If the doctor doesn’t agree with the amount or timeliness of payment, he or she must file Fee Review with the Bureau of Workers’ Compensation. Workers’ comp pays doctors based on a fee schedule. The doctor is not allowed to bill you the balance between what comp pays and what the doctor charged. This is called balance billing and is not permitted by the WC law.
If the Workers’ Compensation Insurance Company wants to challenge the reasonableness or necessity of the doctor’s treatment; they can file for Utilization Review. If the Reviewing doctor finds the treatment unnecessary or unreasonable, you can’t be charged.
