reimbursements for travel,etc.

Author Subject: reimbursements for travel,etc.
Old Timer Posted At 19:05:33 02/06/2001
To Oregon workers:
I need some help folks. I live in central Oregon and must travel to see my docs, one in the Eugene area and the 2nd in Portland. My questions are about reimbursements for travel. Liberty NW, my insurer, refuses to reimburse me for meals when I see my own doctor, even with receipts.

1. Do insurers have to reimburse for meals when traveling to see YOUR OWN DOCTOR? Or just for when you visit the hacks that they send you to see?

2. If it is necessary to stay overnight, when seeing your own doctors, are insurers required to reimburse you for lodging? To what limit?

3. What is the allowance for mileage in Oregon now for case-related trips? I heard that it is .30 per mile.

Any assistance with info here will be appreciated. Thanks.
Old Timer
Tarzan Re: reimbursements for travel,etc. (Currently 1 replies)
Posted At 20:27:01 02/06/2001

Reimbursements are for Honey Moons only, Old Timers do not apply, it will be forgotten, and nogotiated later.

You know that by now!
Resource Re: reimbursements for travel,etc. (Currently 0 replies)
Posted At 22:25:42 02/07/2001

I suspect they are disallowing your out of pocket expenses because there are similar specialists available in your geographic area. The rule on this is as follows:

656.245 (e)Except for services provided under a managed care contract,out-of-pocket expense reimbursement to receive care from the attending physician shall not exceed the amount required to seek care from an
appropriate attending physician of the same specialty who is in a medical
community geographically closer to the worker's home. For the purposes of
this paragraph, all physicians within a metropolitan area are considered to
be part of the same medical community.

Also - look at 436-060-0070 - Reimbursement of Related Services Costs -There are time frames which must be followed and rules about what the insurer must tell you about why you aren't being paid. Look carefully at the letter to make sure they are advising you why these are disallowed. If no reason is listed or the information is supplied to you over 30 days after you asked for the reimbursement, you should appeal their decision not to pay or ask for penalties for the delay.

The current rate is 32.5 cents per mile effective 4-1-2000. See Bulletin
112 for all the details on the current reimbursement rates.

Hope this helps
Old Timer Re: reimbursements for travel,etc. (Currently 0 replies)
Posted At 00:06:10 02/08/2001

Thanks. I'll double check the letter they sent me denying their payment obligations to me.
Old Timer

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