Actually this should be a Workers Comp claim

Dec 15, 2018

  1. somarco
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    somarco That Medicare Expert Guy

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    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.
     
    somarco, Dec 17, 2018
    #11
  2. leevena
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    leevena Guru

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    Very suspicious story for an injury that appears to be minor. Have a great day,
     
    leevena, Dec 17, 2018
    #12
  3. somarco
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    somarco That Medicare Expert Guy

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    I just report what I was told
     
    somarco, Dec 17, 2018
    #13
  4. VolAgent
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    VolAgent Guru

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    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?
     
  5. somarco
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    somarco That Medicare Expert Guy

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    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.
     
    somarco, Dec 17, 2018
    #15
  6. junkman
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    junkman Guru

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    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.
     
    junkman, Dec 18, 2018
    #16
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