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TITLE 28INSURANCE
PART 2TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
CHAPTER 42MEDICAL BENEFITS
SUBCHAPTER AGENERAL MEDICAL PROVISIONS
RULE §42.30Written Communications

(a) A health care provider shall send copies of all written communications related to a claim, including reports, to the carrier and, except for bills, to the injured worker or his or her representative. The provider may require written evidence of representative capacity from the claimant's representative.

(b) A provider shall submit bills for services or supplies to the carrier only. A provider shall send copies of bills to the injured worker, or his or her representative, only upon request.

(c) A provider shall send copies of all written communications, including reports and bills, to the board upon the board's request.

(d) All written communications from providers shall contain the following identifying information, if known:

  (1) the patient's full name, address, and social security number;

  (2) the patient's IAB claim number;

  (3) the date and nature of the injury or illness;

  (4) the employer's name and address;

  (5) the carrier's name;

  (6) the provider's name, address, and federal tax identification number.

(e) A separate report or bill shall be filed for each injury.

(f) All written communications must be legible and reproducible.


Source Note: The provisions of this §42.30 adopted to be effective October 20, 1988, 13 TexReg 4990.

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