How do I confirm if workers’ compensation payments were applied to my medical bills?

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How to Confirm Workers’ Compensation Payments Were Applied to Your Medical Bills in North Carolina

Detailed Answer

Under the North Carolina Workers’ Compensation Act, your employer’s workers’ compensation insurance carrier must pay all reasonable and necessary medical expenses related to an accepted workplace injury. See N.C. Gen. Stat. § 97-25. Because medical providers bill the carrier directly—not you—it can be difficult to verify that each charge was actually paid. Follow the steps below to confirm payments and protect your credit.

1. Gather the Key Documents

  • NC Industrial Commission (NCIC) forms: Look for Form 18, 19, 60, 61, or 62 in your file. These forms confirm claim acceptance or denial.
  • Medical bills and records: Under § 97-25.6, providers must furnish copies of bills and records upon written request.
  • Explanation of Benefits (EOB): The insurer must send an EOB detailing each charge, the NC fee-schedule adjustment, and the amount paid.

2. Check Your NCIC Medical Payment History

The insurance carrier uploads medical payment data to the NCIC’s Electronic Medical Billing system. You (or your attorney) can request a payment ledger from the insurer or the Commission’s clerk. This report shows:

  • Date of service
  • Provider name
  • Amount billed vs. amount paid
  • Date paid

3. Verify Directly with Each Provider

Contact the provider’s billing office and ask for an itemized statement showing workers’ compensation adjustments. Confirm:

  1. The balance is $0 (or the carrier’s reduced fee).
  2. No bill has been sent to collections. If it has, give the collector the claim number and carrier contact.

4. Request a Carrier Payment Summary

Under § 97-97, the carrier must provide an accounting upon reasonable request. Send a certified letter referencing the statute and ask for:

  • EOBs for each provider
  • Total medical payments to date
  • Any pending bills not yet processed

5. Monitor Your Credit Reports

Even when the carrier pays, administrative errors can still trigger collection notices. Check your credit at least quarterly at AnnualCreditReport.com. If a medical debt appears, dispute it immediately and notify the carrier in writing.

6. Use NCIC Form 33 if Problems Persist

If the carrier refuses to pay an authorized bill, you may file Form 33 Request for Hearing. The Commission can order payment and assess a 10% penalty under § 97-18(g).

Helpful Hints

  • Always get pre-authorization for treatment to avoid payment disputes.
  • Keep a claim diary: note dates of appointments, bills received, and people spoken to.
  • Never pay a provider out of pocket before confirming with the carrier—doing so can complicate reimbursement.
  • Save envelopes; postmarks prove when EOBs arrive.
  • If a provider mistakenly bills your private health insurance, alert both insurers so they can coordinate benefits.

Confused or Frustrated? You do not have to navigate workers’ compensation reimbursement alone. Our North Carolina attorneys routinely track medical payments, resolve billing errors, and fight for full benefits. Call us today at 919-313-2737 for a free consultation and peace of mind.

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