Texas Administrative Code
Title 28 - INSURANCE
Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
Chapter 42 - MEDICAL BENEFITS
Subchapter B - MEDICAL COST EVALUATION
Section 42.137 - Utilization Review
Universal Citation: 28 TX Admin Code ยง 42.137
Current through Reg. 49, No. 38; September 20, 2024
(a) The claimant and the carrier may jointly request the board for an informal review and determination of the necessity or proposed medical treatment.
(b) The application shall be accompanied by supporting documentation from one or more health care providers.
(c) The determination of necessity shall be informal, for the purpose of resolving disputes, and shall not be binding on either party.
(d) The carrier shall bear the cost of a review provided under this section.
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