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Workers’ compensation is becoming increasingly sophisticated in Pennsylvania, and our practice group is dedicated to supporting our clients in all areas of the law that affect workers’ compensation claims. In particular, fee review filings have accelerated recently, and we are very familiar with the legal issues associated with the fee review process and its interplay with active workers’ compensation litigation. By becoming involved at the onset of a fee review filing, we are better positioned to defend the interests of employers/carriers.
Medical providers use fee reviews to challenge the timeliness or amount of medical payments made by employers/carriers. Providers are given two opportunities to file a timely application for fee review: (1) within 90 days of their original billing date, or (2) within 30 days after they are provided with notice of a dispute, whichever is later. The fee review process presupposes that liability has been established. Thus, providers’ allegations are accepted at face value during the initial stages. As an unfortunate consequence, employers/carriers may face unjust initial determinations. Disputing a fee review determination requires a de novo appeal, which must be filed within 30 days of the date of the determination. Our attorneys have extensive experience navigating the issues that then arise during fee review hearings, and we provide excellent guidance based on our thorough understanding of CPT codes and types of treatment. Our goal is to handle each case in an efficient and cost-effective manner.
For more information on fee review matters, please contact:
Daniel W. Deitrick, Esquire
412.803.1181 | dwdeitrick@mdwcg.com
Robin M. Romano, Esquire
215.575.2705 | rmromano@mdwcg.com
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