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In the event of a "full match," the health insurer will be eligible to request reimbursement from the workers' compensation insurer. The easiest way to submit a claim is to have your health services provider do it for you, but they can't do so if they're not in the network.Payment disputes between providers and health plans Notices March 17, 2023. Who is considered to be an "uninsured individual" for purposes of providers requesting reimbursement for testing, treatment, or vaccine administration? You can ask that your insurance company reconsider its decision. Insurers have to tell you why they've denied your claim or ended your coverage. We find that, across HealthCare. You will need to submit proof of payment, an itemized bill and a completed Direct Member Reimbursement form. In the event of a "full match," the health insurer will be eligible to request reimbursement from the workers' compensation insurer. You may need to submit your own medical claim if you go to a provider who collects payment up front rather than billing the insurance company.