Workers Compensation Medical Provider Information
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AUTHORIZATION FOR TREATMENT
TPCIGA authorizes reasonable and necessary medical treatment for workers who resided in Texas when injured in the course and scope of their employment for employers with workers’ compensation policies written through insurance carriers designated as “impaired insurers” by the Texas Commissioner of Insurance. Authorization for treatment for injured workers not Texas residents on the date of accident should be obtained from the guaranty fund of the state the worker lived when injured.
TPCIGA anticipates being ready to receive electronic billing beginning 07/01/08.
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MAILING ADDRESS
TPCIGA
9120 Burnet Road
Austin, TX 78758-9969
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PAST DUE BILLS
Due to the transition of claim files from the impaired carrier or handling Third Party Administrator (TPA) to TPCIGA, we do not anticipate processing the medical bills left unpaid by the carrier or TPA in less than ninety (90) days from the date of the carrier’s impairment. Payments will only be made on those bills on which we have received a claim file and have confirmed coverage and compensability.
Medical bills outstanding and unpaid from prior submissions to an impaired carrier or TPA should be re-billed to TPCIGA on a DWC approved form and submitted with a completed, signed and notarized, medical affidavit. Click here for instructions and the affidavit in Adobe PDF or MS Word Doc.
Requests for reconsideration should be completed per DWC rules and regulations. A copy of the bill as it was originally submitted, with a copy of the carrier’s EOB, must be attached. With your request please, provide a detailed position statement explaining why additional reimbursement is needed.
Thank you for your patience and consideration while we begin to receive and process the claims in Liquidation.
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PREAUTHORIZATIONS
For preauthorization requests, contact FORTE, 1-800-580-2273.
Status calls should be directed to Argus Services Customer Service
1-800-487-8711.
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Click for instructions on how to apply for the DWC Approved Doctor List.