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$15,000 medical only program
With this program employers pay the first $15,000 in medical and pharmacy bills for medical-only claims which may reduce premium costs

Employers who choose to participate in the $15K Program pay up to $15,000 in medical and pharmacy bills. They inherently approve the treatment in the normal course of the injury. They cannot authorize or deny treatment, or additional conditions.

 

Enrolling in the program

Call BWC’s employer programs unit at 1-614-441-0745.

Email the employer programs unit.

 

The basics

Employers agree to pay medical providers directly up to $15,000 in medical and pharmacy bills related to the claim.

 

Why participate?

BWC will not charge the employer's experience for payments made under this program, which may result in reduced premium costs.

 

Eligibility requirements

Be current (no more than 45 days past due) on any and all undisputed premiums, administrative costs, assessments, fines and monies due to any BWC administered fund as of the eligibility determination date.

 

How it works

Employers notify employees and medical providers to ensure they send bills directly to the employer for payment. Medical bills paid by the employer under this program will not be included in the experience that BWC uses to calculate the experience modifier.

To maintain eligibility in the program, employers must:

  • Maintain records of the injury and payments, keeping them for five years after the last paid bill;
  • Supply bills paid and proof of payment to BWC within 30 days of a request;
  • Not include paid wages as part of the $15,000 limit;
  • Inform all employees and medical providers of the employer’s participation in the program so medical bills are sent directly  the employer;
  • Pay the provider within 30 days of receipt of a bill;
  • Pay in accordance with BWC’s fee schedule;
  • Not process the Request for Medical Service Reimbursement or Recommendation for Additional Conditions for Industrial Injury or Occupational Disease (C-9) or deny bills if claim/condition is allowed;
  • Report some claims to Medicare beginning July 2010.

Employers can opt-out of participation in the program, or remove an individual claim from the program, by calling 614-441-0745 or emailing the employer programs unit.

For more information

You can review the $15,000 Medical-Only Program fact sheet.

Your employer services specialist at BWC can help you understand this and other programs.