Workers Compensation - 15K Program

• When an Employee is injured at work then it is the responsibility of the Employer (Company) to pay the cost of the injured employee.

• Employers are contracted with Worker's Compensation insurance that pays the bill to medical providers then WC insurance charges the employer and the employer needs to pay the premium cost charged by the insurance company which is very high as per the actual payment of the bill.

• 15K Program allows employers to pay the first $15,000 only in medical and pharmacy bills for medical claims.

• 15K Program allows an employer to pay the medical bills directly to the medical providers, hence employer does not need to pay a premium cost to insurance and spend less money.

• Employers need to enroll in the 15K program to get the benefit of it. After enrollment, the employer needs to notify the employee and provider that the employer will pay the cost of an injury. So the provider can directly send the bill to the employer.

• Once payment of $15,000 is reached then WC insurance starts making payments of other pending amounts. The employer just needs to notify WC insurance with proof that $15,000 has already been paid.

• If the employer does not want any specific claim to be included under the 15K program then it is also authorized to exclude that claim from the 15K program.

• Sometimes it is incorrectly billed to WC insurance and when we call insurance, the rep says that the patient enrolled in the 15K program which means that bill needs to be sent to the employer, not the insurance company.