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Workers' Compensation Health Care Network Data Call

In an effort to monitor the number of injured employees being treated by workers’ compensation health care networks and the use of these networks by insurance carriers, the REG is requesting certain information from each WC health care network certified by the Texas Department of Insurance.

This information request has three parts due on January 31, 2018:

Part A. A list of every injured worker treated in your network or with approved out-of-network services, and with injury dates from June 1, 2016 through May 31, 2017.

This list must also include any claims transferred into your network from another, and claims transferred out of your network since the 2016 data call, regardless of injury dates. Please identify transferred claims at the end of the list under the title “Claims Transferred In” or “Claims Transferred out”.

This list must be accompanied with the data elements (see instructions) each certified network is required to maintain under Title 28, §10.41(a)(7), Texas Administrative Code.

Part B. A list of all WC Insurance Carriers/Political Subdivisions (as defined under §401.011(27), Labor Code) your network has contracted with as of May 31, 2017.

Part C. Letter of certification and attestation to be signed by an authorized network representative.

Each part is fully described in the attachments. Information regarding the identity of an injured worker (Part A) is confidential under §402.083, Labor Code, and accessible to the REG under §405.004(c), Labor Code. Information collected in Part B is confidential under §405.004(d), Labor Code, and will be aggregated and not reported at an individual network level. Part A and Part B will not be accepted as a complete submission unless Part C is received signed by the proper authority, checked, and/or reasons provided for incompletes and inaccuracies. Please email Part C as an attachment in pdf format.

Please submit your responses electronically to WCResearch@tdi.texas.gov by January 31, 2018. If you have any questions concerning any portion of this information request, please contact DC Campbell at 512-676-6820 or by e-mail at WCResearch@tdi.texas.gov

Attachments:



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Last updated: 11/10/2017

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