454-08-0875-m4
DECISION AND ORDER I. INTRODUCTION Childress Regional Medical Center (Provider) appealed a Texas Department of Insurance, Division of Workers Compensation, Medical Review Division (MRD) decision that it is not entitled to reimbursement for services provided to an injured worker (Claimant) because it did not submit its bill for payment (the claim) within the time required […]
453-05-5301-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 […]
454-08-1156-m5
DECISION AND ORDER Texas Mutual Insurance Company (Carrier) requested a hearing to contest a medical fee dispute resolution order issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division) regarding medical services provided to ____ (Claimant). At the hearing, Carrier appeared through its attorney. No other parties appeared or participated in the hearing. […]
453-05-8848-m4
DECISION AND ORDER The Texas Property & Casualty Insurance Guaranty Association for Fremont Indemnity 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] granting additional reimbursement to Twelve Oaks Medical Center (Provider) for a hospital stay provided to Claimant, […]
454-09-0522-m5
DECISION AND ORDER Continental Casualty Company (Carrier) appealed the decision of the Medical Dispute Resolution Division (MDR) of the Texas Department of Insurance, Division of Workers’ Compensation (Division), ordering payment for a chronic pain management (CPM) program that Dennis Gutzman, M.D., provided to an injured worker (Claimant) from January 4, 2005, through March 2, 2005. […]
453-05-5497-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] regarding additional reimbursement to Provider for a hospital stay provided to an injured worker (Claimant). Provider argued that reimbursement for this admission should be […]
453-05-5080-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 […]
453-05-5328-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] ordering additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission should be […]
453-05-5333-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] ordering additional reimbursement to Provider for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for this admission should be […]
453-05-2804-m5
DECISION AND ORDER NUNC PRO TUNC[1] Pacific Employers Insurance Company (Carrier) and Vista Medical Center Hospital (Provider) each requested a hearing on a decision by the Medical Review Division (MRD) of the Texas Department of Insurance, Division of Workers’ Compensation (Division),[2] ordering additional reimbursement, but less than Provider requested, for a hospital stay provided to […]