Provider Frequently Asked Questions
- Who do I call for claims information when seeing an injured worker?
Texas Association of Counties Risk Management Pool
(Claims managed by JI Companies)
Claims Administrator Pre-authorization:
JI Specialty Services, Inc. Phone: 888-580-6805
PO Box 160120 Fax: 888-853-8755
Austin, Texas 78716
Phone: 800-752-6301
Fax: 512-346-9321
http://www.county.org/cms/wc/index.asp
http://www.county.org/cms/whotocontact.asp |
Texas Association of School Boards Risk Management Fund
(Claims are self-managed) PO Box 2010 Pre-authorization:
Austin, Texas 78768-2010 Phone: 800-482-7276
Phone: 800-482-7276 ext. 6654
Fax: 800-580-6720 Fax: 888-777-8272
http://www.tasbrmf.org |
Texas Municipal League Intergovernmental Risk Pool
(Claims are self-managed)
PO Box 149194 Pre-authorization:
Austin, Texas 78714-9194 Phone: 800-482-7276
Phone: 800-537-6655 ext. 6654
http://tmlirp.org/tmlirp/index.html Fax: 888-777-8272
http://www.tmlirp.org/tmlirp/wccontct.htm |
Texas Council Risk Management Fund
(Claims managed by JI Companies)
PO Box 26655 Pre-authorization:
Austin, Texas 78755-0655 Phone: 888-580-6805
Phone: 512-346-5314; 800-580-6467 Fax: 888-853-8755
Fax: 512-346-9321
http://www.tcrmf.org |
Texas Water Conservation Association Risk Management Fund
(Claims managed by JI Companies)
PO Box 26655 Pre-authorization:
Austin, Texas 78755-0655 Phone: 888-580-6805
Phone: 800-580-8922; 512-346-5314 Fax: 888-853-8755
Fax: 512-346-9321
http://www.twcarmf.org |
- What do I do if a patient comes to my office stating they are an injured worker?
Always contact the associated Risk Pool before treating any injured worker.
- Where do I find DWC forms?
DWC 73 & DWC69 forms are available by clicking the Resources tab or at the Department of Insurance web site at: http://www.tdi.state.tx.us/srch/searchwc/query.asp.
These forms can be filled out and saved to the patient’s file or your system. You can submit via email or fax to your associated Risk Pool adjuster.
- Where can I find pre-authorization forms?
Forms for the five risk pools are available by clicking the Resources tab or you may contact the assigned Risk Pool adjuster.
- How do we know which specialists to refer patients to?
A directory of providers is available by clicking the Provider Directory tab.
- What do I do if I want to refer a patient to a specialist that is not on the provider list?
Please complete a Provider Nomination Form. After internal approvals, we will contact your referral with information on joining our physician panel.
- Are there any additional steps to perform when prescribing a Rx?
No, simply give the injured worker the prescription.
- How do I file claims and associated forms?
We prefer that you file electronically, but you can fax or email claims as well. Please contact your assigned adjuster for available options associated with the injured worker's risk pool.
- What is the typical turnaround time for payment?
State guidelines are 45 days from receipt of a bill. Our risk pools turnaround time averages within 15-20 days.
- Where can I find the ODG guidelines?
http://www.tdi.state.tx.us/wc/rules/adopted/adopted.html#disabilitymgmt
ODG guidelines can be purchased and are available in print or online copy. One source for purchasing this material can be found at http://www.worklossdata.com/texasform.htm.
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