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September 30, 2011   Medical Service Providers Must Keep Track of New Two-Year Worker’s Compensation Statute of Limitations
By Colin E. Connor

Although it might not have received the same attention as the texting while driving ban, the Indiana General Assembly also modified the Indiana Worker’s Compensation Act (“Act”) during the 2011 session.  Under the Act, injured workers are entitled to receive medical care for a work-related injury, which is paid for by their employer’s worker’s compensation insurer.  In the event a medical care provider is not paid (or is not paid in full) for services rendered under the Act, the provider may file an Application for Adjustment of Claim for Provider Fee before the Indiana Worker’s Compensation Board (“Board”) to recover the unpaid portion of the medical bill.  As of July 1, 2011, the Act now contains a two-year statute of limitations from the date on which the defendant or its insurer first responds to the medical care provider’s request for payment. See Ind. Code § 22-3-3-5(d).  The statute also now requires that medical service providers pay a $60 filing fee with each balance billing application (this fee is waived for applications resulting from a complete denial).  Up to ten individual claims involving the same employer, insurer, or billing review service may be combined into one application, but only if the amount of each individual claim does not exceed $200.


After submitting a worker’s compensation bill, medical service providers must carefully track all correspondence from the patients’ employers and insurers.  When the medical service provider receives the first written communication from a patient’s employer or its insurer, the medical service provider should calendar two years from that date as the statute of limitations for filing an application disputing the payment received.  For more information on the new law’s effects on medical service providers or Plews Shadley Racher & Braun LLP’s representation of medical service providers, please contact Fred Emhardt, Shelley Jackson, or Colin Connor.         

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