Detailed Answer
1. Review Your Explanation of Benefits (EOB)
When your medical provider submits a bill under Alaska workers’ compensation, the insurer issues an Explanation of Benefits (EOB). This document shows each service, the billed amount, the amount paid by the insurer, and any patient responsibility. Ask your provider or insurer for copies of all EOBs.
2. Request Itemized Medical Bills and Payment Records
Obtain an itemized statement from each medical provider. Compare these statements to your EOBs. Look for dates of service, procedure codes, and charges. The insurer must pay or deny medical bills within 30 days under AS 23.30.095 (https://www.akleg.gov/basis/statutes/text/23.30.095).
3. Compare Bills to Insurer Records
Create a simple spreadsheet listing each date of service, the billed amount, the insurer’s paid amount, and any remaining balance. Highlight discrepancies where the insurer shows zero payment but your provider indicates an outstanding balance.
4. Contact Your Employer’s Workers’ Compensation Insurer
If you find unpaid bills, call or write to your employer’s insurer. Provide them with the itemized bill and ask for an updated EOB or payment confirmation. Insurers often correct small clerical errors if you supply clear documentation.
5. File a Claim with the Alaska Workers’ Compensation Board
If the insurer fails to apply payments or unjustly denies coverage, you can seek a board order. Under AS 23.30.100 (https://www.akleg.gov/basis/statutes/text/23.30.100), you may petition the Alaska Workers’ Compensation Board. Use Form 07–6103 (Worker’s Notice of Injury and Claim for Compensation) to request a hearing. Include copies of your itemized bills, EOBs, and correspondence with the insurer.
Helpful Hints
- Keep all EOBs, bills, and correspondence in a dedicated folder.
- Track calls and emails with dates, times, and agent names.
- Use clear labels on your spreadsheet: Date, Service, Billed, Paid, Balance.
- Notify your employer’s claims administrator in writing if you spot an unpaid bill.
- Consult the Alaska Workers’ Compensation Board website for forms and deadlines.
Disclaimer: This article is for informational purposes only and does not constitute legal advice. Consult a qualified attorney or the Alaska Workers’ Compensation Board for guidance on your specific situation.