DWC Announces Performance Based Oversight (PBO) Results
DWC has released the 2022 Insurance Carrier Performance Based Oversight assessment. The Texas Department of Insurance, Division of Workers’ Compensation (DWC) regularly evaluates insurance carriers and health care providers for compliance with Texas Labor Code §402.075 and 28 Texas Administrative Code §180.19. Performance Based Oversight (PBO) is a review of Insurance carriers’ and health care providers’ performance in selected areas of compliance. The purpose of PBO is to:
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- Set performance expectations
- Reward excellence
- Encourage continuous improvement
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Insurance carriers were assessed on their performance in five measures:
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- paying initial temporary income benefits;
- processing initial medical bills;
- processing requests for reconsideration of medical bills;
- submitting initial payment data by electronic data interchange (EDI); and
- submitting medical bill processing data by EDI.
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More information as to the assessment methodology can be found at https://www.tdi.texas.gov/wc/pbo/documents/pbo2022ic.pdf.
Insurance Carrier Tier Assessments Overall Results
| Assessment Year | Insurance Carriers | High Tier Performers | Average Tier Performers | Poor Tier Performers |
| 2022 | 136 | 41 | 82 | 13 |
For more information, contact James Sheffield, FOL Managing Shareholder, at jrs@fol.com or the Division at PBO@tdi.texas.gov.
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