134.800
(a) This subchapter applies to all insurance carriers as defined in Labor Code § 401.011(27), including insurance carriers that have contracted with or established a workers’ compensation health care network as defined in Labor Code § 401.011(31-a) and insurance carriers that provide medical benefits in a manner authorized by Labor Code § 504.053(b)(2). All insurance […]
134.801
(a) The purpose of this subchapter is to prescribe the reporting requirements for information and data submitted to the division and to adopt by reference the implementation guide and specifications necessary for successful electronic data interchange transaction processing. The reporting of information and data is necessary to maintain a statewide data base of medical charges, […]
134.806
(a) Insurance carriers shall not report medical EDI records for health care services: (1) rendered outside the United States; (2) related to dates of injury before January 1, 1991; (3) rendered at a Federal health care facility and the health care facility does not provide the insurance carrier with the data required to be reported; […]
137.5
(a) This section applies to all case management services as defined by Labor Code § 401.011(5-a) that are provided under Labor Code Title 5 to injured employees by an insurance carrier on or after September 1, 2011. (b) This section does not apply to case management services: (1) subject to Insurance Code Chapter 1305; (2) […]
133.500
(a) For electronic transactions conducted before January 1, 2012, the division adopts by reference the following electronic medical bill processing standards as adopted by the United States Department of Health and Human Services in 45 CFR § 162.1102(b) and § 162.1602(b): (1) Professional Billing–the ASC X12N 837, Health Care Claim: Professional, Volumes 1 and 2, […]
133.501
(a) Applicability. (1) This section applies to the exchange of electronic medical bill data in accordance with §133.500 of this title (relating to Electronic Formats for Electronic Medical Bill Processing) for professional, institutional/hospital, pharmacy, and dental services. This section applies to all electronic medical bill processing, including transactions for medical services rendered under the provisions […]
126.7
Repealed eff. February 1, 2011
180.6
Repealed eff. January 9, 2011
180.7
Repealed eff. January 9, 2011
180.11
Repealed eff. January 9, 2011