453-02-3979-m4-etal
DECISION AND ORDER I. INTRODUCTION Vista Healthcare, Inc. (Vista) requested a hearing to contest decisions by the Medical Review Division (MRD) of the Texas Workers’ Compensation Commission (Commission) denying additional payment for ambulatory surgical center services.[1] Vista operated ambulatory surgical centers (ASCs) in Houston, Texas, and provided surgical services to patients not requiring in-patient hospitalization. […]
453-03-3297-m4
DECISION AND ORDER I. INTRODUCTION In a decision dated April 15, 2003, the Medical Review Division (MRD) of the Texas Workers’ Compensation Commission[1] (Commission) denied the request for additional reimbursement filed by Vista Medical Center Hospital (Vista) for services it provided to a workers’ compensation claimant during an inpatient hospital admission on August 18 through […]
453-03-0540-m4
DECISION AND ORDER I. INTRODUCTION Vista Healthcare, Inc. (Vista) requested a hearing to contest a decision by the Medical Review Division (MRD) of the Texas Workers’ Compensation Commission (Commission) denying additional payment for ambulatory surgical center services.[1] Vista operated ambulatory surgical centers (ASCs) in Houston, Texas, and provided surgical services to patients not requiring in-patient […]
453-05-1481-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, […]
453-04-4568-m5
DECISION AND ORDER Don A. Salyer, D.C. (Petitioner) seeks reimbursement for office visits, electrical stimulation, therapeutic procedures, mechanical traction, supplies/materials, and myofascial releases provided to a worker’s compensation claimant from September 27, 2002 through December 20, 2002. The Texas Workers’ Compensation Commission (Commission),[1] acting through an independent review organization (IRO), denied reimbursement on the basis […]
453-03-0502-m4-etal
DECISION AND ORDER I. INTRODUCTION Vista Healthcare, Inc. (Vista) requested a hearing to contest decisions by the Medical Review Division (MRD) of the Texas Workers’ Compensation Commission (Commission)[1] denying additional payment for ambulatory surgical center services. Vista[2] operated ambulatory surgical centers (ASCs) that provided outpatient surgical services to patients not requiring hospitalization. Vista billed ZNAT […]
453-04-5186-m5
DECISION AND ORDER Zenith 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 Provider for a hospital stay provided to Claimant, an injured worker. Carrier argued that reimbursement for this admission should not be […]
453-03-0545-m4
DECISION AND ORDER I. INTRODUCTION Vista Healthcare, Inc. (Vista) requested a hearing to contest a decision by the Medical Review Division (MRD) of the Texas Workers’ Compensation Commission (Commission) denying additional payment for ambulatory surgical center services.[1] Vista operated ambulatory surgical centers (ASCs) in Texas, providing surgical services to patients not requiring in-patient hospitalization. Vista […]
453-03-0546-m4
DECISION AND ORDER I. INTRODUCTION Vista Healthcare, Inc. (Vista) requested a hearing to contest a decision by the Medical Review Division (MRD) of the Texas Workers’ Compensation Commission (Commission) denying additional payment for ambulatory surgical center services.[1] Vista operated ambulatory surgical centers (ASCs) in Texas, providing surgical services to patients not requiring in-patient hospitalization. Vista […]
453-03-0547-m4
DECISION AND ORDER I. INTRODUCTION Vista Healthcare, Inc. (Vista) requested a hearing to contest a decision by the Medical Review Division (MRD) of the Texas Workers’ Compensation Commission (Commission) denying additional payment for ambulatory surgical center services.[1] Vista operated ambulatory surgical centers (ASCs) in Texas, providing surgical services to patients not requiring in-patient hospitalization. Vista […]