• Increase Text Icon
  • Decrease Text Icon
  • Email Icon
  • Print this page
You are here: Home . wc . carrier . ur

Review of Medical Necessity (Utilization Review)

All health care rendered in the Texas workers' compensation system is subject to review by a Utilization Review Agent (URA) for the insurance carrier for reasonableness and medical necessity. This is called utilization review.

Utilization review can take place:

  • Prospectively (before services are provided)
  • Concurrently (extension of on-going health care)
  • Retrospectively (after services are provided)

How to Become / Act as URA

In the Texas workers' compensation system, utilization review may be performed only by a certified URA. URAs are certified by the Texas Department of Insurance.

For definitions, rules, reporting requirements, and information related to becoming a certified utilization review agent, see the Utilization Review homepage.

For more information, contact:

Last updated: 09/06/2014

Contact Information and Other Helpful Links