Hello – I am Al Frowiss from AtomicWorkers.com. We are an independent Advocate and Representative for current and former Energy Employee workers and their families.
For many claimants, the goal of filing a claim is to “get the White Card” … and the expectation is that once you have been approved and received a ‘White Card” that everything going forward will be hunky-dory. Well, as many learn, that is rarely the case. There are many issues that come up which require constant vigilance and follow up with a worker’s various medical providers.
This blog is one of several I plan to publish in the hope that the facts and myths are more universally known. In this writing, I touch on finding and working with Medical Providers who accept the “White Card”.
Finding Medical Providers/Doctors
Many workers think that because this is a Federal program that “all” medical providers will accept the “White Card”. That is not the case, unfortunately. Coverage and availability of providers who are familiar with the program tend to be concentrated in and around current or former work sites like Tri-Cities in Washington State, Albuquerque/Santa Fe, Las Vegas, and Knoxville/Oak Ridge/Eastern TN. But, even in these markets there are challenges.
Not every provider is on this program, and they are not required to do so. In the Denver/Boulder/Longmont metro (near Rocky Flats), there are issues in that many providers outsource their billing processing to third parties, and these third parties do not want the hassle. Kaiser Permanente is an example where the white card works for some specialists, but not others. Medical providers submit bills to these 3rd parties and the 3rd parties do not have the authority to make changes in bill “coding” related to approved ICD 9/ICD 10 codes, which is a topic that could cover many pages.
Finding doctors is not so simple, as many have found out after the fact. The list that is available on the DEEOIC web site is simply an archive of providers who have submitted direct expenses in the past. They are not “preferred” providers by any means. These providers have signed up electronically so that they can directly submit patient invoices, which is good for workers. And to be clear, any medical provider who has a Medicare # can also sign up to be a provider under OWCP/EEOICP … it is a few forms and then a few weeks to month(s) to get into the system and assigned an OWCP #. The benefit is faster pay to them, and you never (well, seldom) see an invoice … unless someone screws up billing. If you have more than one insurance provider, which many people do, there are always issues as to what services are being billed to which insurance provider.
That said, most of the major providers associated with Longmont United (in Colorado) and UC Health (all locations) do accept/honor the “white card”. Not sure about Banner Health System. And closer into Denver, Presbyterian and SCL do. In Washington, Kadlec/Trios participate, Presbyterian in NM, and UT Medical in Knoxville TN does as well. Mayo Clinics and MD Anderson support this program. There are many more.
The issue I hear all the time is the hospital advocates/billing staff do not know how to “find” the designator for the OWCP/DEEOIC or “Energy Employees Occupational Illness Compensation Program”. Apparently, some systems have it entered different ways. Then, there is often confusion in that workers call this a “Worker Compensation” claim, and red lights go off that this must be a State Workers Compensation program. Some medical providers try to avoid state worker’s comp programs. However, this is a Federal compensation program, that pays higher rates for nearly all services than Medicare … however, DEEOIC is a pain to work with and they are slow payers. All too often, workers run into doctors/providers who do not want anything to do with this program based on prior bad experiences and payment hassles.
Referrals to Other Providers
Another common issue is the expectation that when your primary medical provider refers you out to another facility/provider for tests or other services which are presumed to be related to, or preventative care for, your approved condition, that such services will be covered by the “White Card”. As an example, if you are referred out to a Radiation Oncologist, or to an Imaging Center for a periodic checkup, often these are operated as distinct, separate businesses, and the same rules/guidelines for billing applies. You need to double check that the alternate provider:
a) accepts the white card also, and
b) that the referral clearly notes your approved medical condition and ICD 10 code … because that approved code must be included on all bills from all providers.
In our practice, we strive to set appropriate expectations for our clients. Use of the ‘White Card” is the most important value a worker may receive from this program. As well, this is one of the largest areas of frustration and disappointment.
If you would like to learn more about how AtomicWorkers can help, please contact us directly. We return calls and emails promptly.