Actually this should be a Workers Comp claim

[somarco]

Her WC encounter was earlier, different claim, assaulted by a student.

She was told to contact HR and file a WC claim. Long wait (her story) to get a referral to a WC provider, not urgent care. Another long wait to get MRI or CT. Another long wait to get approval for rehab, etc.

 

[leevena]

Her WC encounter was earlier, different claim, assaulted by a student.

She was told to contact HR and file a WC claim. Long wait (her story) to get a referral to a WC provider, not urgent care. Another long wait to get MRI or CT. Another long wait to get approval for rehab, etc.

Very suspicious story for an injury that appears to be minor. Have a great day,

 

[somarco]

I just report what I was told

 

[VolAgent]

Somewhere an attorney is crying into his/her drink right now. She likely had hurt any WC, unsafe workplace, etc. claims. It sounds like she has been injured twice by students during her career?

 

[somarco]

This is a special needs school. Most are foster children of crack addicts, parent(s) in jail, all have been abused.

Not your typical elementary school.

 

[junkman]

Patient is liable for the claim and accepts financial responsibility as part of check in process at provider.

Carriers pay according to contract. Medical carrier would determine whether it is an "allowed charge " and pay accordingly. In this case, it could be denied if determined to be a WC claim.

WC carrier would then pay according to contract and consider network/non-network, precert etc as per contact.

Technically, the employer is liable and the WC carrier is indemnifying the employer. I wouldn't risk my health because of a crappy WC contract or network. That's what attorneys are for.

 

[hopiyatsi]

Should have been more clear.

Group health insurance typically is non-occ. WC (workers comp), not UC (unemployment comp), claims are Vidmate iTunes Notepad++ generally not a covered item under an employer group health plan.

Doesn't matter if the plan is fully insured or self funded.

Many years ago stop loss reinsurers tried to develop a 24 hour product. Never got off the ground unless someone figured out how to make it work since then.

Injured on the job but does not file WC claim. Too many horror stories about long waits, unable to get proper care . . . the same complaints people have about govt provided, taxpayer funded health care.