Workers Compensation Office Policies
As of 9/1/2017, we chose to terminate our work comp MPN agreements. We will accept a limited amount of our Work Comp cases at the discretion of the physician on duty each day.
Hilltop Medical Clinic/Hilltop Medical Clinic West is designated as the Primary Treating Physician (PTP) for your worker’s compensation injury. Your PTP will diagnose, treat and will decide the best work status for your specific injury. Each time you are seen at the clinic, you must wait for the nurse to check you out after seeing the doctor. The nurse will give you your work status, the date of your next visit and any medications that we can dispense here. Since we have no narcotics, you may need to go to the pharmacy for prescriptions that are not in our pharmacy formulary. If the doctor gives you work restrictions, you are expected to speak to your employer as soon as possible to see if your employer can accommodate these restrictions. It is your responsibility to remember your recheck date at the clinic. Not returning on the correct date may affect your worker’s compensation benefits and may delay checks from your insurance company. Your employer cannot accommodate the restrictions they may decide to keep you off work.
Chronic injuries: It is our goal of our physicians to help you improve as much as possible and return to work as soon as possible. Sometimes your injury may prevent you from returning to your normal work for quite some time. If you cannot improve to your pre-injury status, or if you have permanent restrictions, the PTP may designate you Permanent and Stationary in regards to your injury. Once this is done, you will need to have your family doctor or another physician see you for any treatment and follow-up. Hilltop Medical Clinic/Hilltop Medical Clinic West will not continue to follow you for this injury and non-acute problems.
Denied Claims: If your claim is denied by the insurance company, it will be your financial responsibility to pay the clinic for any bill you incurred during your treatment for this injury. You will also be responsible for any treatment by other healthcare professionals incurred for therapy you may have received.
Forms: The doctor will complete required forms for your work comp injury free of charge. There will be a $15 charge for any other forms related to your disability or your own personal finances. It will be your responsibility to pay this charge at the time the forms are completed.
You are ONLY to discuss your work comp injury with physician: Your employers contracted work comp insurance may be liable today for your injury that you are being seen for. If you choose to discuss unrelated work comp illness/injuries with the physician today you will be asked by the receptionist to provide private insurance and payment for that portion of your visit that is unrelated to your work comp injury. Some unrelated illness/injury examples are blood pressure, insomnia, sore throat, rash, pains in other areas not related to your work comp injury.
Physicians: Your case may be followed by different physicians. Your care will be documented in our system so that any physician will be able to continue treatment. You will see the physician that we schedule you for on your return visits. You will not be able to request the same physician for repeat visits.
OWCP CLAIMANTS: It is your responsibility to provide our office with the CLAIM number as soon as you receive it. You will receive this information with your acceptance letter on your claim. If the proper paperwork is not completed/filed and we do not receive the claim number, you will be financially responsible for any and all medical bills incurred at our office and any office we have referred you to for treatment on this work related injury.
AUTHORIZATION TO RELEASE MEDICAL INFORMATION
By law Hilltop Medical Clinic / Hilltop Medical Clinic West cannot release all your medical information concerning your injury or industrial accident without your written authorization. To ensure all aspects of your injury are disclosed to the insurance company and to your employer it is important for you to give Hilltop Medical Clinic/Hilltop Medical Clinic West the authority to release all this information. Each time you come to the clinic for a recheck, Hilltop Medical Clinic/Hilltop Medical Clinic West will send information to both the insurance company and your employer about your visit, treatment and work status.
I hereby authorize Hilltop Medical Clinic / Hilltop Medical Clinic West to furnish to my insurance company, employer, Attorney or legal representative, all information concerning my industrial injury or accident. This includes how I injured myself, medical history, treatment and work status.
ANY PERSON WHO MAKES OR CAUSES TO BE MADE ANY KNOWINGLY FALSE OR FRAUDULENT MATERIAL STATEMENT OR MATERIAL REPRESENTATION FOR THE PURPOSE OF OBTAINING OR DENYING WORKERS COMPENSATION BENEFITS OR PAYMENTS IS GUILTY OF A FELONY.
Once you have signed this agreement, you agree to all the terms and conditions contained herein and the agreement will be in full force and effect.