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Texas Administrative Code (Last Updated: March 27,2024) |
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TITLE 28. INSURANCE |
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PART 2. TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION |
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CHAPTER 133. GENERAL MEDICAL PROVISIONS |
| SUBCHAPTER A. GENERAL RULES FOR MEDICAL BILLING AND PROCESSING |
| § 133.1. Applicability of Medical Billing and Processing |
| § 133.2. Definitions |
| § 133.3. Communication Between Health Care Providers and Insurance Carriers |
| § 133.4. Written Notification to Health Care Providers of Contractual Agreements for Informal and Voluntary Networks |
| § 133.5. Informal Network and Voluntary Network Reporting Requirements to the Division |
| SUBCHAPTER B. HEALTH CARE PROVIDER BILLING PROCEDURES |
| § 133.10. Required Billing Forms/Formats |
| § 133.20. Medical Bill Submission by Health Care Provider |
| § 133.30. Telemedicine, Telehealth, and Teledentistry Services |
| SUBCHAPTER C. MEDICAL BILL PROCESSING/AUDIT BY INSURANCE CARRIER |
| § 133.200. Insurance Carrier Receipt of Medical Bills from Health Care Providers |
| § 133.210. Medical Documentation |
| § 133.230. Insurance Carrier Audit of a Medical Bill |
| § 133.240. Medical Payments and Denials |
| § 133.250. Reconsideration for Payment of Medical Bills |
| § 133.260. Refunds |
| § 133.270. Injured Employee Reimbursement for Health Care Paid |
| § 133.280. Employer Reimbursement for Health Care Paid |
| SUBCHAPTER D. DISPUTE OF MEDICAL BILLS |
| § 133.305. MDR--General |
| § 133.306. Interlocutory Orders for Medical Benefits |
| § 133.307. Medical Fee Dispute Resolution |
| § 133.308. MDR of Medical Necessity Disputes |
| § 133.309. Alternate Medical Necessity Dispute Resolution by Case Review Doctor |
| SUBCHAPTER G. ELECTRONIC MEDICAL BILLING, REIMBURSEMENT, AND DOCUMENTATION |
| § 133.500. Electronic Formats for Electronic Medical Bill Processing |
| § 133.501. Electronic Medical Bill Processing |
| § 133.502. Electronic Medical Billing Supplemental Data Requirements |