Texas Administrative Code
Title 28 - INSURANCE
Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
Chapter 42 - MEDICAL BENEFITS
Subchapter A - GENERAL MEDICAL PROVISIONS
Section 42.30 - Written Communications

Universal Citation: 28 TX Admin Code ยง 42.30

Current through Reg. 49, No. 38; September 20, 2024

(a) A health care provider shall send copies of all written communications related to a claim, including reports, to the carrier and, except for bills, to the injured worker or his or her representative. The provider may require written evidence of representative capacity from the claimant's representative.

(b) A provider shall submit bills for services or supplies to the carrier only. A provider shall send copies of bills to the injured worker, or his or her representative, only upon request.

(c) A provider shall send copies of all written communications, including reports and bills, to the board upon the board's request.

(d) All written communications from providers shall contain the following identifying information, if known:

(1) the patient's full name, address, and social security number;

(2) the patient's IAB claim number;

(3) the date and nature of the injury or illness;

(4) the employer's name and address;

(5) the carrier's name;

(6) the provider's name, address, and federal tax identification number.

(e) A separate report or bill shall be filed for each injury.

(f) All written communications must be legible and reproducible.

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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