Texas: E-Billing for Workers’ Comp System Begins Jan. 1

September 18, 2007

The Texas Department of Insurance Division of Workers’ Compensation issued a reminder that workers’ compensation system health care providers and insurance carriers are required to be able to exchange medical billing and reimbursement data electronically beginning Jan. 1, 2008.

To facilitate the transition from paper billing to electronic billing, the DWC has developed resources for these system participants.

For health care providers, TDI will provide a comprehensive list of insurance carriers and federal employer identification numbers (FEINs) for those insurance carriers on the TDI website. The FEINs can be used by health care providers when submitting an electronic bill. TDI also will provide names and identification numbers for insurance carrier agents/clearinghouses provided by the insurance carriers.

For insurance carriers, TDI is providing DWC Form-027, Carrier Representative Information Submission Form, to enable the submission and regular updating of required electronic billing information for the insurance carriers’ processing agent(s). Insurance carriers are required to submit the name, FEIN and contact information for their agent(s) to TDI by Sept. 20, 2007.

TDI recently posted the Clean Claim and Electronic Medical Billing and Payment Workers’ Compensation Companion Guides to the TDI Web site at http://www.tdi.state.tx.us/wc/ebill/index.html#ebcg.

The guides include information on both electronic and paper billing requirements to assist health care providers and insurance carriers with the submission and processing of workers’ compensation medical bills. System participants should consult the companion guides for medical bill processing whether bills are being submitted on paper claims or electronically.

TDI will post updates and information for system participants about the transition to electronic medical billing on the TDI web site at http://www.tdi.state.tx.us/wc/ebill/index.html.

Source: Texas Department of Insurance

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