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Health care provider webinars

DWC has new health care provider webinars

Learn what’s new in Texas workers’ compensation, including:

  • Filling out the CMS-1500, Health Insurance Claim Form
  • 2022 conversion factors
  • Preauthorization process, and more!

TXCOMP changes

Starting Monday, September 19, 2022, doctors and their administrators must use TXCOMP to: 

  • accept and manage designated doctor appointments, and 
  • file required reports online.  

Learn more...

Health care provider training and resources

Comp Connection for Health Care Providers logoAs part of its mission, the Division of Workers’ Compensation (DWC) strives to educate and inform health care providers how to effectively work within the system and provide high quality medical care that encourages and facilitates the injured employee’s safe return to employment.

This page offers information and resources for health care providers to help them understand their roles and responsibilities in the Texas workers’ compensation system.

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A health care provider is a health care facility or a health care practitioner.

A health care facility is a hospital, emergency clinic, outpatient clinic, or other facility, that is appropriately licensed to provide inpatient and outpatient medical services to patients experiencing acute illness or trauma.

A health care practitioner is an individual who is licensed to provide health care, or an unlicensed individual who provides health care under the direction or supervision of a doctor.

With some exceptions, health care practitioners are not required to complete training or apply to DWC to provide health care to Texas injured employees. The exceptions are:

  • Doctors who conduct maximum medical improvement and impairment rating examinations (certifying examinations) must complete the DWC required training and testing.
  • Designated doctors are required to complete training and testing and apply to be included on the DWC list of designated doctors.
  • Health care practitioners who assist doctors with the range of motion, strength, and sensory testing portion of a certifying examination must complete the required impairment rating training.
  • Health care practitioners and health care facilities providing services to injured employees who are required to receive health care through a workers’ compensation health care network (network claims) must complete the network credentialing process. To join a workers’ compensation health care network, see Information for Providers and Find a certified WCNet on the TDI website.

All health care practitioners who participate in the Texas workers' compensation system must:

  • have an active license to practice in their jurisdiction;
  • not have any disciplinary orders restricting them from participating in the Texas workers’ compensation system; and
  • disclose the identity of any other health care provider they have financial interest in to DWC. To learn more, see the fast facts about financial disclosure. You can report financial interest online through TXCOMP.

TXCOMP is an automated system that allows public access to non-confidential workers' compensation information. Through TXCOMP the public can verify an employer has workers’ compensation insurance coverage, find an insurance carrier’s claims administration information, find a health care provider by type and location, and report certain information including financial interest.

You can disclose financial interest through TXCOMP by creating a health care provider profile. To create a profile, go to TXCOMP and select 'Online Access Request' from the main menu.

Watch the Health Care Provider Roles and Responsibilities on-demand training to learn more about health care provider requirements.

To learn more about providing health care services to Texas workers' compensation patients, please check out this webpage, including the on-demand training.

Texas government employers are required to provide workers’ compensation coverage to their employees. However, in Texas, private employers can choose to carry workers' compensation insurance coverage, but it is not required in most cases.

The Texas Workers' Compensation Act (Texas Labor Code, Title 5) and rules only apply to Texas employers that provide workers’ compensation coverage to their employees.

Covered employers:

  • Individual employer workers' compensation commercial policy (Subscriber)
  • Company holds a Certificate of Authority as a Certified Self Insurer in Texas (Certified self-insureds)
  • Self-insured government employer

Watch the Identifying a Workers’ Compensation Patient on-demand training to learn how to verify if an employer has workers' compensation coverage. 

DWC has an online tool to help verify if an employer has workers' compensation insurance coverage. 

For help with coverage, contact. Coverage.verification@tdi.texas.gov

Texas workers' compensation fee guidelines establish reimbursement of medical services and treatments for non-network care.

Watch the Reimbursement for Professional and Workers’ Compensation Specific Services and Texas Workers’ Compensation Reimbursement Policies and Methodologies on-demand training to learn about Texas workers' compensation reimbursement policies. 

A basic goal of the Texas workers’ compensation system is to facilitate the safe and timely return of injured employees to productive roles in the workplace.

Treating doctors and other health care providers have an important role in achieving this goal by providing high-quality medical care, that promotes restoration of the injured employee's physical condition facilitating the employee's return to work.

To learn more, watch the Return to Work and the DWC Form-073, Work Status Report on-demand training.

Every injured employee must have a treating doctor who is primarily responsible for the efficient management and coordination of the health care for an injured employee's compensable injury.

A doctor is defined in the Texas Workers’ Compensation Act as a doctor of medicine, osteopathic medicine, optometry, dentistry, podiatry, or chiropractic who is licensed and authorized to practice.

The injured employee's initial choice of a treating doctor does not require approval. However, to change the treating doctor, the injured employee must submit an Employee Request to Change Treating Doctor (DWC-053) to the DWC for approval (non-network claim) or notify the workers’ compensation network of the change (network claim).

Non-network claims

§126.9 Choice of treating doctor and liability for payment

DWC-053, Employee Request to Change Treating Doctor

DWC-053S, Solicitud del Empleado para Cambiar de Médico de Tratamiento

Network claims

§10.85 Selection of Treating Doctor; Change of Treating Doctor

A designated doctor is selected by DWC to resolve questions about an injured employee's medical condition or resolve a dispute about a work-related injury or illness.

To learn more about designated doctors, visit the Designated doctor homepage

Designated Doctor video

For more information, contact: CompConnection@tdi.texas.gov