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Medical fee dispute resolution (MFDR) pre-recorded training

MFDR training

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Medical fee dispute resolution

The Texas Division of Workers’ Compensation helps resolve disputes about the amount of payment due for health care that is medically necessary and appropriate to treat a compensable injury.

  • 28 Texas Administrative Code (TAC) Section 133.305 - General
  • 28 TAC Section 133.307 - MDR of Fee Disputes 

Request form: DWC Form-060 Medical Fee Dispute Resolution Request

Ways to file:

Electronically:
Fax: 512-490-1044
Secure File Transfer Protocol (SFTP), using “MFDR-DWC060 Request” as the file name.
For more information, contact DWC at eFiling-Help@tdi.texas.gov.

US Postal Service mail:
Texas Department of Insurance 
Division of Workers’ Compensation 
PO Box 12050 
Austin, Texas 78711

Delivery service or in person:
Division of Workers’ Compensation, MC: HS-MFDR
Texas Department of Insurance
1601 Congress Avenue, Suite 6.900
Austin, Texas 78701

An injured employee may file a medical fee dispute if the employee:

  1. Paid out-of-pocket for medical services for the compensable injury;
  2. Asked the workers’ compensation carrier for a refund in writing; and
  3. The insurance carrier either:
    • did not respond within 45 days;
    • denied your request; or
    • did not pay the full amount you asked for.

Request form: DWC Form-060 Medical Fee Dispute Resolution Request

Ways to file:

Fax: 512-490-1044

US Postal Service mail:
Texas Department of Insurance 
Division of Workers’ Compensation 
PO Box 12050 
Austin, Texas 78711 

Delivery service or in person:
Division of Workers’ Compensation, MC: HS-MFDR
Texas Department of Insurance
1601 Congress Avenue, Suite 6.900
Austin, Texas 78701
 

Learn more: Medical fee dispute resolution for injured employees (PDF)

El empleado lesionado puede presentar una disputa por honorarios médicos si el empleado:
  1. Pagó de su propio bolsillo por los servicios médicos de la lesión compensable;
  2. Pidió a la aseguradora de compensación para trabajadores un reembolso por escrito; y
  3. La aseguradora ya sea:
    • no respondió dentro del transcurso de 45 días;
    • denegó su solicitud; o
    • no pagó la cantidad completa que usted solicitó.

Formulario de solicitud: Formulario DWC-060s, Solicitud para Resolución de Disputas por Honorarios Médicos

Formas en las que puede presentar la solicitud:

Por correo electrónico: MedFeeDispute-Submission@tdi.texas.gov

Por fax:
512-490-1044

Por correo postal:
Texas Department of Insurance
Division of Workers’ Compensation
PO Box 12050
Austin, Texas 78711

Por servicio de entrega o en persona:
Division of Workers’ Compensation, MC: HS-MFDR
Texas Department of Insurance
1601 Congress Avenue, Suite 6.900
Austin, Texas 78701

 

Obtenga más información: Resolución de disputas por honorarios médicos para empleados lesionados (PDF)

Use the Medical fee dispute resolution decisions search tool to find MFDR decisions from 2014 to present. 

You can search by:

  • tracking number,
  • the date the dispute was received, or the decision was issued, and
  • by the name of the requestor or respondent.
Medical Fee Disputes – Updated October 2022

Categories

Active

Abated

Air Ambulance Services

n/a

2,285

Workers’ Comp Specific Services

177

 

Professional Services

126

 

Pharmacy Services

124

 

Facility Services

53

 

Preauthorization

43

 

Other

73

 

Totals

596

2,285

Resources

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

Last updated: 11/8/2022