Michigan Administrative Code
Department - Labor and Economic Opportunity
Workers Compensation Agency
Workers' Compensation Health Care Services Rules
Part 1 - GENERAL PROVISIONS
Section R. 418.10116 - Provider responsibilities

Universal Citation: MI Admin Code R. 418.10116

Current through Vol. 24-16, September 15, 2024

Rule 116.

(1) When a licensed facility or practitioner licensed in this state treats an injured worker for a compensable work-related injury or illness and bills the workers' compensation carrier, the carrier shall reimburse the licensed provider or facility the maximum allowable payment, or the providers' usual and customary charge, whichever is less, pursuant to these rules. A provider shall do both of the following:

(a) Promptly bill the carrier or the carrier's designated agent after the date of service.

(b) Submit the bill for the medical services provided to treat an injured worker on the proper claim form, to the workers' compensation carrier or the carrier's designated agent and attach the documentation required in part 9 of these rules.

(2) If the provider has not received payment within 30 days of submitting a bill, then the provider shall resubmit the bill to the carrier and add a 3% late fee.

(3) Only the provider shall alter or change in any way the provider's original bill.

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