(a) Selection of treating doctor. An injured employee
who lives within the service area is entitled to the employee's initial
choice of a treating doctor from the list provided by the network
of all treating doctors under contract with the network who provide
services within the service area in which the injured employee lives
in accordance with Insurance Code §1305.104(a), concerning Selection
of Treating Doctor.
(b) Change of treating doctor. An injured employee
who is dissatisfied with the employee's initial choice of treating
doctor or with an alternate treating doctor may select an alternate
or subsequent treating doctor in accordance with Insurance Code §1305.104(b)
- (e).
(c) Use of specialist as treating doctor. An injured
employee with a chronic, life-threatening injury or chronic pain related
to a compensable injury may apply to the network's medical director
to use a specialist that is in the same network as the injured employee's
treating doctor in accordance with Insurance Code §1305.104(f)
- (i).
(d) Request for an HMO primary care physician or provider
as the employee's treating doctor. An injured employee required to
receive health care services within a network may select as the employee's
treating doctor a doctor who the employee selected, prior to injury,
as the employee's primary care physician or provider under Chapter
843, as the terms "physician" and "provider" are defined in that chapter.
The network must grant an employee's request for an HMO primary care
physician or provider to serve as the employee's treating doctor if
the physician or provider agrees to abide by the terms of the network's
contract and comply with Insurance Code Chapter 1305, Subchapters
D - I, and rules adopted under those subchapters, as applicable to
treating doctors.
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