Workers' Compensation

What is Bureau of Workers’ Compensation (BWC) $15K Medical-Only Program?

Abby Oakman
Medical Bills
Reading time 2 Mins
Published on Aug 31
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The Bureau of Workers’ Compensation (BWC) 15K Medical-Only Program offers employers the opportunity to pay up to the first $15,000 in medical and pharmacy bills for medical only claims. By directly paying the medical expenses, employers may potentially lower their workers’ compensation premiums.

Once enrolled in the program, any claim from enrollment date forward will be included in the program. If the injured worker misses more than 7 days of work, the claim is no longer eligible and is removed from the 15K program. Once the medical bills reach $15,000 limit, it is the employer or their representative’s responsibility to remove the claim from the program. It is important to remember employers may remove any claim from the program or opt out of the program completely at any time. When a claim is removed from the 15K Program, the employer’s Managed Care Organization will begin to manage the claim and the BWC will pay the medical bills.

PROGRAM (EMPLOYER) REQUIREMENTS:

  1. Remain current on any premiums or monies due to the BWC
  2. Maintain all records of injuries and payments for five years after last paid bill
  3. Supply bills paid and proof of payment to BWC within 30 days of request
  4. Inform all employees and medical providers of the employer’s participation in the program
  5. Pay the provider within 30 days of receipt of the bill
  6. Accept all treatment requests while a claim is enrolled in the program
  7. Register and report claims to Medicare when applicable (federal requirement) www.cms.gov

SHEAKLEY SERVICES:

  1. Review of medical bills for appropriateness
  2. Re-price medical bills to the BWC fee schedule
  3. Provide vouchers for each bill received
  4. Recommend when a claim should be considered for removal of the program
  5. Supply notification to employer once claim limit has been reached
  6. Notify BWC if Employer requests removal of a claim
  7. Annual Financial Analysis provided prior to renewal of rating programs
  8. Customized claim reports

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