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Worker Comp Contract

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What is Workers’ Compensation?

 

Workers’ compensation insurance is a type of business insurance that provides benefits to employees who suffer work-related injuries or illnesses. Specifically, this insurance helps pay for medical care, wages from lost work time and more.

How workers’ compensation networks work?

Workers' compensation networks are a type of managed care plan. Employers who choose to use a workers’ compensation network buy coverage from an insurance company that either contracts directly with doctors and hospitals, or contracts with a certified network, for a panel of doctors and hospitals to treat employees with work-related injuries and illnesses. Self-insured employers and political subdivisions can also set up networks or contract with existing networks.

 

The insurance company pays for all medically necessary care for a work injury or illness. It also pays any income and disability benefits due the employee. The insurance company may review treatments to decide whether they’re medically necessary. If it decides that a treatment isn’t medically necessary, the injured employee or the doctor can ask the company to reconsider.

 

Networks operate in geographic service areas, usually by county. Employees who live in the service area must use doctors and hospitals in the network for care related to a work injury or illness. There are exceptions for emergencies and for employees who get prior approval to go to an out-of-network doctor. Injured employees who don’t live in the service area aren’t required to use network providers. The insurance company must still pay for their care, however.

 

How can a Healthcare Agency become a Provider?

Healthcare providers must have a contract with the Federal Government to become a provider of care for workers compensation. Texas Regulatory Licensing and Compliance administrates this process so that the provider can be approved. The Provider must have a current state license and in good standing. See the time frames and cost below.

Worker's Comp Contracts are Available to These Types of Providers

 

 

 

Type                                                Processing                       

 

Home Health Agency                      1-2 Months                           $975

Personal Assistance Services          1-2 Months                          $975

Medical Clinics                                 1-2 Months                          $975

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