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At a Glance:
Title:
08069
Date:
May 23, 2008
Status:
Medical Fees

08069

May 23, 2008

DECISION AND ORDER

This case is decided pursuant to Chapter 410 of the Texas Workers’ Compensation Act and Rules of the Division of Workers’ Compensation adopted thereunder.

ISSUES

A benefit contested case hearing was opened on May 1, 2008 and closed on May 23, 2008, to decide the following disputed issues:

  1. Whether the health care provider is not entitled to reimbursement of $434.88 plus interest for services rendered to the Claimant on March 13, 2007, for the compensable injury of _____?

PARTIES PRESENT

Carrier appeared and was represented by HW lay representative. Respondent/Subclaimant appeared and was represented by JEL, lay representative.

AGREEMENT

The parties reached an agreement. The agreement only resolves the issues to be decided at this hearing. The agreement does not resolve all issues regarding the claim and is not a settlement.

In this decision, this Agreement section constitutes the findings of facts and the Decision Section constitutes the conclusions of law.

The Hearing Officer found:

  1. Carrier delivered to the health care provider a single document stating the true corporate name of Carrier, and the name and street address of Carrier’s registered agent, which document was admitted into evidence as Hearing Officer’s Exhibit Number 2.

The parties agreed as follows:

  1. The Texas Department of Insurance, Division of Workers’ Compensation, has jurisdiction to hear this case.
  2. Venue is proper in the (City) Field Office of the Texas Department of Insurance, Division of Workers’ Compensation.
  3. On _____, Claimant was the employee of (employer) when he sustained a compensable injury.

Medical Fee Dispute Resolution Findings and Decision entered on March 14, 2008, for services rendered by (health care provider) to the Claimant on March 15, 2007.

  • Carrier properly denied the original amount sought of $579.84 for services rendered by (health care provider) to the Claimant on March 15, 2007.
  • DECISION

    (Health care provider) is not entitled to reimbursement of $434.88 plus interest which was originally ordered to be paid by Carrier in the Medical Fee Dispute Resolution Findings and Decision entered on March 14, 2008, for services rendered by (health care provider) to the Claimant on March 15, 2007. Carrier properly denied the original amount sought of $579.84 for services rendered by (health care provider) to the Claimant on March 15, 2007.

    ORDER

    Carrier is not liable for the benefits at issue in this hearing. Claimant remains entitled to medical benefits for the compensable injury in accordance with Section 408.021.

    The true corporate name of the insurance carrier is (SELF-INSURED) and the name and address of its registered agent for service of process is

    HW

    (ADDRESS)

    (CITY), TEXAS (ZIP CODE)

    Signed this 23rd day of May, 2008.

    Charles T. Cole
    Hearing Officer

    End of Document
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