A Workers’ Compensation insurance carrier may request a “utilization review” of medical bills submitted by a medical provider to determine if the treatment is reasonable, necessary and related to the work injury. When a utilization review is requested, the insurance carrier does not have to pay for the bills at issue unless the utilization review is decided in the doctor’s favor.
In a recent case, a medical provider contacted David F. Stern after his treatment was deemed not reasonable or related to a patient’s work injury. Mr. Stern successfully petitioned on behalf of the doctor to have the medical bills paid. This case is an example of how Pond Lehocky Stern Giordano can help secure continuing medical care and payment of medical bills on behalf of both clients and medical providers.