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At a Glance:
Title:
09008-m4r
Date:
August 15, 2008

09008-m4r

August 15, 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 contested case hearing was held on August 15, 2008, to decide the following disputed issues:

  1. Whether the health care provider is not entitled to reimbursement of $76.94 for services rendered to Claimant on June 21, 2007?

Upon agreement of the parties, the following issue was added:

  1. Whether the Self-Insured timely paid the medical bill for services rendered by the health care provider to Claimant on June 21, 2007?

PARTIES PRESENT

Petitioner/Carrier appeared and was represented by JG, attorney. Respondent/Subclaimant appeared and was represented by JE, 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 she sustained a compensable injury.
  4. The medical bill for the date of service of June 21, 2007, was reimbursed to (Health Care Provider) in a timely manner, and no interest is due.
  5. The health care provider is not entitled to additional reimbursement for services rendered to Claimant on June 21, 2007.

DECISION

The preponderance of the evidence supports the reversal of the Medical Fee Dispute Resolution Findings and Decision rendered on May 29, 2008, in (MFDR No.). The medical bill for the date of service of June 21, 2007, was reimbursed to (Health Care Provider) in a timely manner, and no interest is due. The health care provider is not entitled to additional reimbursement for services rendered to Claimant on June 21, 2007.

ORDER

No additional reimbursement is required from the Self-Insured to the health care provider for services rendered by the health care provider to Claimant on June 21, 2007, in accordance with this decision, the Texas Workers’ Compensation Act, and the Commissioner’s Rules.

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

CSC

(ADDRESS)

(CITY), TEXAS (ZIP CODE)

Signed this 15th day of August, 2008.

Charles T. Cole
Hearing Officer

End of Document
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