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The Texas Department of Insurance, Workers’ Compensation Division (TDI-DWC) has just released a list of payers, clinics, and doctors for whom disciplinary measures have been imposed due to violations of the Texas Labor Code and DWC rules.

TDI Imposes Penalties for Doctors, Payers

A brief review of the Enforcement Actions posted for 2011 reveals that roughly half of the entities who received disciplinary action were insurance companies and payers who often failed to pay timely.   “No surprise there”, you may be thinking.

So who made up the other half?  Healthcare providers!

 Yes, you read correctly.  Doctors, clinics, specialty groups and hospitals made up the other half.  The top reasons were:

  •  Failed to timely file and/or accurately complete TDI-DWC forms, reports or records
  • Improperly billed an injured employee for workers’ compensation medical services provided

 Disciplinary actions against healthcare providers ranged from additional training and education to fines ranging from $1000 to $6000, to banishment from the workers compensation system.

 Be certain your providers and staff are trained and understand the importance of providing the necessary forms and documentation requested by the DWC and that your billing staff understand the rules and prohibitions against billing injured employees for worker’s compensation related services.

 Healthcare Reimbursement Services regularly provides billing services for healthcare providers of workers compensation patients.  If we may be of assistance, please call 888-211-1118 today!