453-05-7755-m4
DECISION AND ORDER Texas Mutual 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 Twelve Oaks Medical Center (Provider) for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for […]
453-03-3903-m4
DECISION AND ORDER Vista Healthcare, Inc. (Vista) contested a decision by the Medical Review Division (MRD) of the Texas Workers’ Compensation Commission (Commission) denying additional payment for ambulatory surgical center (ASC) services.[1] Until November 2002, Vista operated an ASC in Houston, Texas. ASCs provide surgical support services to patients not requiring hospitalization. In this case, […]
454-06-0843-p1
DECISION AND ORDER Highmark Casualty Insurance Company (Carrier) challenges a medical interlocutory order (MIO) issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division), requiring it to pay for certain office visits and medications provided over a ninety-day period. The Administrative Law Judge (ALJ) concludes, under the specific facts of this case, that […]
453-04-8083-m4
DECISION AND ORDER Spring Branch Medical Center (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 […]
453-05-5162-m4
DECISION AND ORDER Valley Regional Medical Center (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 […]
453-05-5473-m4
DECISION AND ORDER Northwest Regional 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 based […]
453-05-5548-m4
DECISION AND ORDER Texas Orthopedic 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 based […]
453-05-7756-m4
DECISION AND ORDER Texas Mutual 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 Twelve Oaks Medical Center (Provider) for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for […]
453-05-7863-m4
DECISION AND ORDER Texas Mutual 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 Twelve Oaks Medical Center (Provider) for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for […]
453-05-7865-m4
DECISION AND ORDER Texas Mutual 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 Twelve Oaks Medical Center (Provider) for a hospital stay provided to Claimant, an injured worker. Provider argued that reimbursement for […]