[QUOTE=Puddin]You go, Terri43!
I was thinking about you when I started this thread. After my seemingly heartless suggestion on another thread. Sorry
Anybody have it figured out on how to "work" the system?[/QUOTE]
I am not sure that we have figured out how to *work* the system, but we got through the first time due to attention to detail and diligence. When I sent in the claim, I had set it up like a term paper, with every doc report, every test result, a diary of events and documentation of the incident that lead to the claim. It had a table of contents and a complete list of everyone that my husband saw along with their information. I think that we flabbergasted them.
It has been one year, last month that he was injured and three months since the surgery. He was approved about six months through, first time through. Everyone told us that it could not be done. I set out with the mind set that it could.
There is a box on most paperwork that you have to fill out for the doctors which asks if you are there as a result of an accident and then it has another box to list the insurance. We were told that we would be committing insurance fraud if we lied and used our private insurance and that it would be hard to win a WC case later. We just told each place that we went that it was WC and that we were waiting for approval. All of them took our private insurance and billed them anyway. When we got approved, the insurance company went after the money. But, at no time did we ever not check that box. We always told them it was WC. We left it to the doctors and insurance companies to work it out.
WC does not pay as much as the insurance companies, this is why the docs bill the insurance first.
If I had it to do over again, I would do it the same and no attorneys. If you have a clear cut case, why hand over 40% to someone else????
just a thought,