Billing questions
The stress of dealing with medical bills could impact the recovery from your injury. The information on this page can help reduce the stress.
Once your claim is filed
While your claim is being evaluated, medical providers cannot bill you for treatment. If SAIF accepts the claim, we will pay your medical providers for medically reasonable and necessary care related to your accepted conditions.If your claim is accepted, your doctors will be reimbursed for treatment related to your accepted condition. (In Oregon, the amount of the payment is determined by the Oregon Workers' Compensation Fee Schedule.)
If your claim is denied, all benefits will stop. You are not eligible for benefit payments while your claim is in a denied status, except for interim medical benefits if you are also covered by a qualified health plan.
If you appeal the denial, you do not have to pay for medical services while the appeal is in process and/or until the denial is final.
If you received a bill
If your claim has been accepted, you should not have to pay any out-of-pocket expenses associated with your claim. Be sure to tell your doctor that you have filed a workers' compensation claim.If you have purchased medications for your injury, submit your receipts to SAIF for reimbursement. Use this form for your request.
Occasionally you may be required to pay for medical treatment. Your attending physician should notify you when your treatment begins under what conditions you would have to pay for medical care. For example, you will be responsible for payment if you:
- Seek treatment for conditions not related to the accepted compensable injury or illness
- Seek treatment that has not been prescribed by your doctor
- Seek palliative care after your claim has been closed without obtaining prior approval from SAIF or the state Workers' Compensation Division (Palliative care is a medical service that makes you feel better but doesn't heal a medical condition.)
- Seek treatment from a doctor who is not a member of a managed care organization (MCO) panel after you have been enrolled by SAIF in an MCO
- Seek treatment after you have been notified that the treatment is experimental, outmoded, unscientific, or unproven
If you do not have insurance
You can get help with medical care even if you are not covered by health insurance at the time of your injury.The Oregon Prescription Drug Program is available to Oregonians who do not have prescription drug coverage. Learn more at state of Oregon OPDP website.Oregon Health Plan (OHP) provides health care coverage to low-income Oregonians at little or no cost. See the OHP website to find out if you are eligible and how to apply.Reimbursement
An injured worker has the right to request reimbursement for out-of-pocket expenses such as prescriptions or mileage driven to and from their medical provider appointments. Submit these requests to us within two years of the service date.- Download the Request for Reimbursement of Expenses form (F-3056) in English or (F-3056s) Spanish.
- Learn more about prescription drug coverage