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The Flint Journal “Ask the Attorney” Column

Q. I was injured at work, my employer’s comp insurance refused to pay my medical bills claiming the bills were not coded properly, and now I am getting hounded by a collection agency for payment. What should I do? (June 2015)

A. If these bills were incurred because of a work injury, the medical provider must code the bill under the Workers’ Compensation Health Care Service Codes in order to get paid at the state-approved billing rates. Sometimes, the problem is an obnoxious collection agent who can be sued under the Fair Debt Collections Act for fraudulent or overbearing collection tactics. Sometimes it is medical providers who do not like to get paid at these regulated rates. Sadly, I have even seen some doctors try to make patients lie and state their injury is not work-related in order to obtain treatment so they can bill more lucrative insurance. This is neither fair to injured workers nor legal. The provider is required to code the bills properly for payment. If the rates are too low or unfair, injured workers, doctors, and citizens in general, should assert their power to demand higher rates with the state regulators in Lansing. The medical community has organized fierce resistance to recent legislative proposals that doctors treating auto accident victims be paid at the same lower rates as those treating injured workers. Doctors should be just as motivated to demand decent payment rates for treating workers too. If your doctors think the rates for certain procedures are too low, I encourage them to call me, and I will assist them in getting their voices heard in Lansing. In any event, if the doctor or collection agent still refuses to get the bills properly coded, you can call me for assistance in getting these bills coded…and paid.

–Attorney Robert J. MacDonald