Provider Requirements
In order to participate in the provider panel of a certified WCNet (network) a provider must enter into a written agreement with the network. A network's provider contract must include certain provisions which are required under TIC §1305.152 and 28 TAC §10.42(b). Some of the provisions that are mandatory in a network-provider contract include, but are not limited to:
- Injured employee will be "Held Harmless"
- Provider agrees to follow the network's treatment guidelines
- Network will not engage in retaliatory action
- Provider will comply with all applicable state & federal requirements
To see all of the network-provider contract requirements, please refer to the referenced statute and rule.
LHL720 - Provider Contract Checklist
Other Applicable Statutes and Rules
Carrier Requirements
In order to obtain the authority to operate as a certified WCNet (network) an applicant must enter into a written agreement with an insurance carrier. A network's insurance carrier contract must include certain provisions which are required under TIC §1305.154 and 28 TAC §10.41(a). Some of the provisions that are mandatory in a network-carrier contract include, but are not limited to:
- Injured employee will be "Held Harmless"
- Carrier retains ultimate responsibility for compliance
- Network's role is to provide certain required services
- Network-carrier contract will comply with all applicable state & federal requirements
To see all of the network-carrier contract requirements, please refer to the referenced statute and rule.
LHL721 - Carrier Contract Checklist
Other Applicable Statutes and Rules
Delegated Entities Requirements
In order to delegate contracting with providers for care; provider credentialing; the operation of a quality improvement program; or the operation of a complaint system to a third party, a certified WCNet (network) must enter into a written agreement with the third party, i.e., the delegated entity (DE).
A network's DE contract must require the DE to be subject to all the requirements of Chapter 1305 of the TIC and related rules. Some of the requirements that apply to a network-DE contract include, but are not limited to the following:
A network-DE contract must be executed when submitted to the department for approval and must include the network's contingency plan for use in the event that the network must re-assume any/all delegated functions. Network-DE contracts that are not executed will not be reviewed by the department for compliance.