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At a Glance:
Title:
09108
Date:
March 6, 2009
Status:
Medical Fees

09108

March 6, 2009

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 February 26, 2009 to decide the following disputed issue:

Is the health care provider, Dr. JDR, entitled to reimbursement of medical fees in the amount of $146.44 for health care services (CPT Code 73720-RT-26) rendered to Claimant on October 3, 2008?

PARTIES PRESENT

Petitioner/Sub-Claimant appeared Pro Se. Respondent/Self-Insured appeared and was represented by RMJ, attorney at law.

AGREEMENT

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

In this decision, the Agreement section includes findings of fact, and the Decision section constitutes conclusions of law.

The Hearing Officer found that Self-Insured delivered to Claimant a single document stating the true corporate name of Self-Insured and the name and physical address of Self-Insured's registered agent, which document was admitted into evidence as Hearing Officer's Exhibit No. 2.

The parties agreed as follows:

The health care provider, Dr. JDR, is entitled to reimbursement of medical fees in the amount of $146.44 for health care services (CPT Code 73720-RT-26) rendered on October 3, 2008.

DECISION

The parties agree that the health care provider, Dr. JDR, is entitled to reimbursement of medical fees in the amount of $146.44 for health care services (CPT Code 73720-RT-26) rendered on October 3, 2008.

ORDER

Self-Insured is ordered to pay benefits in accordance with this decision, the Texas Workers' Compensation Act, and the Commissioner's rules.

The true corporate name of Self-Insured is (SELF-INSURED); and the name and address of its registered agent for service of process is:

VICE PRESIDENT & GENERAL COUNSEL

(ADDRESS)

(CITY), TX (ZIP CODE)

Signed this 6th day of March 2009,

Sandra Weber Fullerton,
Hearing Officer

End of Document
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