Division Actively Reviewing Accuracy of Carriers’ Claim Administration Contact Information
Rule 124.2 was amended in late 2019 to clarify how carriers must provide notice of their claim service administration contact information. In connection with the rule amendment, the Division created a new form, the DWC-121, to capture the information. The form should be completed by the carrier and filed with the Division through the carrier’s Austin Representative.
The agency is currently investigating whether carriers have complied with the rule requirements. Those carriers that the Division determines are not compliant are being contacted individually to update their contact information. The Division is requesting that the information be completed and updated on a DWC-121 before the end of the year.
Upon receipt of a completed DWC-121, the Division will update the carrier’s claim administrative contact information in TXCOMP. Carriers should verify the accuracy of the claim administration contact information by reviewing the information listed with the Division. To do so, carriers can go to the TXCOMP homepage on the Division’s website and click the TXCOMP link. Carriers should then select the “Locate Insurance Carrier” link and, after locating and clicking the link for the appropriate underwriting company, click “View Claim Administration Contact.”
The contact information for each carrier administration claims function shall include mailing address, telephone number, facsimile number, and email address as appropriate. This contact information may be provided either in the form of a single Uniform Resource Locator (URL) for a web page created and maintained by the insurance carrier that contains the required information or through an online submission to the Division.
(A) Coverage verification (policy issuance and effective dates of policy);
(B) Claim adjustment;
(C) Medical billing;
(D) Pharmacy billing (if different from medical billing); and
(E) Preauthorization.
If the web page option is used the page must contain the date on which it was last updated and an email address or other contact information to which a user may report problems or inaccuracies. Carriers must update the contact information or URL within 10 working days after any change is made.
If you have questions concerning this process, please contact Sharissa Karol or Bobby Stokes in our office.
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