453-05-7876-m4
DECISION AND ORDER Liberty Mutual Fire Insurance Company (Carrier) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division)[1] ordering additional reimbursement to Corpus Christi Medical Center (Provider) for a hospital stay provided to Claimant, an injured worker. Although the parties agree […]
453-08-0788-m5
DECISION AND ORDER Job Injury Rehab Center, also known as Rehab 2112 (Provider), challenges the decision of an Independent Review Organization (IRO) upholding the decision of _____ (Carrier) to deny reimbursement for a work hardening program provided to an injured worker (Claimant). Because Provider failed to prove the program was medically necessary for the treatment […]
453-05-6483-m4
DECISION AND ORDER American Home Assurance Company (Carrier) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division),[1] concluding that it owed additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Carrier argued that the Stop-Loss Exception […]
453-05-7782-m4
DECISION AND ORDER Mid-Century Insurance Company (Carrier) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division)[1] ordering additional reimbursement paid to Spring Branch Medical Center (Provider) for a hospital stay provided to Claimant, an injured worker. Provider also requested a hearing […]
453-05-8033-m4
DECISION AND ORDER Southwest Texas Methodist Hospital (Provider) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division)[1] denying additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission should be […]
453-05-6409-m4
DECISION AND ORDER Vista Medical Center Hospital (Provider) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division),[1] denying additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission should be […]
453-05-6531-m4
DECISION AND ORDER Vista Medical Center Hospital (Provider) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division),[1] denying additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission should be […]
453-05-1679-m4
DECISION AND ORDER Liberty Mutual Fire Insurance Company (Carrier) requested a hearing on an October 8, 2004 decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division)[1] ordering additional reimbursement to Vista Medical Center Hospital (Provider) for a hospital stay provided to Claimant, an injured worker.[2] MRD […]
453-05-6402-m4
DECISION AND ORDER Vista Medical Center Hospital (Provider) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division)[1] denying additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission should be […]
453-05-6404-m4
DECISION AND ORDER Vista Medical Center Hospital (Provider) requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division)[1] denying additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission should be […]