Fee Review

In the case Jaeger v. Bureau of Workers’ Compensation Fee Review Hearing Office (CAN), the Court upheld the decision that Dr. Jaeger was not to be awarded additional compensation for treatment, because the insurer properly followed the procedures under 34 Pa. Code §127.207. The insurer had sent the ten day notice to the doctor indicating that the treatments were being down coded and explained the reasoning for it. The doctor failed to respond and was paid for the down coded treatment. The Court held that the insurer does not have to show proof the notice was received just that it was sent.