Texas Administrative Code
Title 28 - INSURANCE
Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
Chapter 134 - BENEFITS-GUIDELINES FOR MEDICAL SERVICES, CHARGES, AND PAYMENTS
Subchapter I - MEDICAL BILL REPORTING
Section 134.806 - Records Excluded from Reporting
Universal Citation: 28 TX Admin Code ยง 134.806
Current through Reg. 49, No. 38; September 20, 2024
(a) Insurance carriers shall not report medical EDI records for health care services:
(1) rendered outside the United
States;
(2) related to dates of
injury before January 1, 1991;
(3)
rendered at a Federal health care facility and the health care facility does
not provide the insurance carrier with the data required to be
reported;
(4) related to an injured
employee's travel reimbursement as provided in §
134.110
of this title (relating to Reimbursement of Injured Employee for Travel
Expenses Incurred); or
(5) related
to a request for reimbursement by a health care insurer in accordance with the
provisions of Labor Code §
409.0091.
(b) Insurance carriers shall not report interest and penalty payments paid on health care services, medical cost containment expenses, medical bill review expenses or data transmission expenses in medical EDI records.
(c) This section is effective September 1, 2011.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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