453-03-0571-m4
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 (ASC) services. Vista operated ASCs in the Houston area that provided outpatient surgical services to patients not requiring hospitalization. Vista […]
453-03-0505-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 […]
453-03-0507-m4-etal
DECISION AND ORDER I. INTRODUCTION Vista Healthcare, Inc. (Vista) and American Casualty Company of Reading, Pennsylvania (Carrier) 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 (ASC) services. Vista operated ASCs in Texas, providing surgical services to patients […]
453-03-3102-m4-etal
DECISION AND ORDER Vista Healthcare, Inc. (Vista) contested decisions 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 these cases, Vista […]
453-03-3121-m4
DECISION AND ORDER I. INTRODUCTION 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 25 through 31, 2001. Because Vista submitted neither medical […]
453-03-4014-m4
DECISION AND ORDER I. INTRODUCTION The Medical Review Division (MRD) of the Texas Workers’ Compensation Commission[1] (Commission) granted Vista Medical Center Hospital’s (Vista’s) request for additional reimbursement of $39,604.92 for services it provided to a workers’ compensation claimant during an inpatient hospital admission on October 27 through 30, 2001. MRD determined that TMIC improperly carved […]
453-03-4032-m4
DECISION AND ORDER I. INTRODUCTION The Medical Review Division (MRD) of the Texas Workers’Compensation Commission[1] (Commission) granted Vista Medical Center Hospital’s (Vista’s) request for additional reimbursement of $90,035.56 for services it provided to a workers’ compensation claimant during an inpatient hospital admission on December 3 through 6, 2001. MRD determined that TMIC improperly carved out […]
453-04-4232-m4
DECISION AND ORDER I. INTRODUCTION The Medical Review Division (MRD) of the Texas Workers’ompensation Commission[1] (Commission) granted Vista Medical Center Hospital’s (Vista’s) request for additional reimbursement of $85,446.93 for services it provided to a workers’ compensation claimant during an inpatient hospital admission on September 6 through 14, 2001. MRD determined that the carrier, Texas Mutual […]
453-04-5366-m4
DECISION AND ORDER I. INTRODUCTION The Medical Review Division (MRD) of the Texas Workers’ Compensation Commission[1] (Commission) granted Vista Medical Center Hospital’s (Vista’s) request for additional reimbursement of $125,914.01 for services it provided to a workers’ compensation claimant during an inpatient hospital admission on March 25 through April 2, 2002. MRD determined that TMIC improperly […]
453-04-8356-m4
DECISION AND ORDER I. INTRODUCTION The Medical Review Division (MRD) of the Texas Workers’Compensation Commission[1] (Commission) granted Vista Medical Center Hospital’s (Vista’s) request for additional reimbursement of $120,301.55 for services it provided to a workers’ compensation claimant during an inpatient hospital admission on November 6 through 22, 2001. MRD determined that TMIC improperly carved out […]