TIP OF THE WEEK - October 14, 2013

1. TIP OF THE WEEK - October 14, 2013 Can a claimant’s treating physician bill them in excess of what OWCP has paid for medical treatment and services for their accepted worker’s compensation claim? Injured Worker Billed $100 OWCP pd $ 50 Due $ 50

2. ANSWER: • No, “If a provider’s bill is reduced by OWCP in accordance with its fee schedule or other tests of reasonableness, the provider is not allowed to charge you as a claimant for the remainder of the bill.” • “By submitting a bill and/or accepting payment, the provider signifies that the service for which reimbursement is sought was performed as described and was necessary. In addition, the provider thereby agrees to comply with all regulations set forth in this subpart concerning the rendering of treatment and/or the process for seeking reimbursement for medical services, including the limitation imposed on the amount to be paid for such services.” 20 C.F. R. § 10.801 Reference: Division of Federal Employees' Compensation (DFEC) Information for Injured Workers http://www.dol.gov/owcp/dfec/regs/compliance/infoinjuredwrkers.htm 20 C.F.R. §10.801 & 20 CFR §10.813 http://www.dol.gov/owcp/dfec/laws.htm If you have a question or topic for Tip of the Week, contact your District 6 Liaison, Jacksonville, FL