Unfortunately, at this time, we are out of network with the Department of Labor and cannot provide treatment for patients with this type of insurance.
Typically, we take referrals or appointment requests directly from the insurance company or a referring office that has approval for treatment from the insurance company. If you know the claim details related to your injury, you can always call and pass the information to our Workers' Compensation Coordinator, but we cannot guarantee that we will be given the approval for treatment from the insurance company with every request.
Once you have come in for an appointment with the physician, the clinical team will ensure all the documents from the appointment are given to the Workers' Compensation Coordinator. At at that point, we will reach out directly to the adjuster from the insurance company — providing notes from the appointment(s), the work status that is provided to the patient and employer, and any orders for procedures that are ordered by the physician. We will seek the approval for recommended procedures and provide the insurance company with any additional documentation to work towards an approval. Once the approval is obtained, either the Workers' Compensation Coordinator or patient care coordinators will reach out to the patient to discuss. In the case of a denial from the insurance company, the patient will get a call directly from the Workers' Compensation Coordinator to discuss next options.
If you receive any billing from our office and you have a workers compensation claim open, please reach out to our Workers' Compensation Coordinator so we can look into the issue. You should not receive any billing directly from our office, if you have an open and active work comp claim.
Please do not hesitate to give us a call when you have questions over the care you are receiving. We can answer all questions about ongoing treatment with our physicians, as well as have constant contact with the Workers' Compensation adjusters on all cases.
All second opinions under workers' compensation must be approved by the insurance company before scheduling. Additionally, these types of appointments cannot be scheduled directly with the patient. If you are wanting a second opinion from a physician at Capital Orthopaedics, please reach out to your claims adjuster to discuss and request assistance in initiating this process.
Staff at Capital Orthopaedics has no control over benefits provided from workers' compensation insurance. You will need to reach out to your employer or adjuster with the insurance company directly to discuss your benefits. We are not aware of, nor do we have any insight to offer, regarding benefits for active care, reimbursement, or the settlement that may be given.
If you are wanting a copy of the medical records from the appointment, please reach out to our Workers' Compensation Coordinator directly at 515-222-9675 (WORK). This staff member will navigate you through the process of obtaining these records.
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