If I am an employees primary care physician under his health insurance plan, can I serve as the employees treating doctor for a compensable injury?
A. Perhaps. If the employees health insurance is a health maintenance organization (HMO) plan and the employee selected you to be his or her primary care physician prior to the work-related injury, the employee may select you as the treating doctor for the work-related injury. However, you must agree to follow all the terms and conditions of the network’s contract and comply with the Workers’ Compensation Health Care Network Act (Chapter 1305, Insurance Code) and applicable rules. After the agreement is reached, if you need to refer the employee to other providers for care, you must refer to network providers.
Related Questions
- I offer health insurance to my employees through an HMO plan. Can my employees go to their HMO primary care physician instead of a workers’ compensation health network doctor?
- If I am an employee’s primary care physician under his health insurance plan, can I serve as the employee’s treating doctor for a compensable injury?
- What if my employees want to designate their HMO primary care physician as their treating doctor?
