Texas Mutual Insurance Company (workers compensation)

Texas Mutual's published healthcare provider line (888-53-CLAIM). Per the provider FAQ, providers can use it to retrieve claim numbers (Option 2 then Option 1), check bill status after 30 days, learn whether an employer participates in the WorkWell, TX network, and discuss preauthorization. Workers' compensation: a claim number and the adjuster or injured-worker identification are usually required; coverage is determined by the claim (not by a member ID), and state fee schedules and rules govern billing.

Texas Mutual states it partners with Jopari Solutions for medical billing and payments; payer ID 22945. Jopari support is for electronic billing and payment-portal help (include the provider TIN and reference Texas Mutual). Texas requires electronic bills except for small providers meeting the stated exemption. Not a Texas Mutual claims-decision line. Workers' compensation: a claim number and the adjuster or injured-worker identification are usually required; coverage is determined by the claim (not by a member ID), and state fee schedules and rules govern billing.

Per the provider FAQ, a request for reconsideration goes by fax and must include a copy of the original bill, the EOB and a claim-specific explanation under DWC Rule 133.250. Providers have 10 months from date of service to appeal. Medical fee disputes go to the Texas Department of Insurance, not this fax. Workers' compensation: a claim number and the adjuster or injured-worker identification are usually required; coverage is determined by the claim (not by a member ID), and state fee schedules and rules govern billing.

Per the provider FAQ, complete the preauthorization request form with clinical documentation and email it or fax it. The address is a utilization-review referral mailbox published on Texas Mutual's page. Preauthorization addresses medical necessity, not compensability, and is not a guarantee of payment. Workers' compensation: a claim number and the adjuster or injured-worker identification are usually required; coverage is determined by the claim (not by a member ID), and state fee schedules and rules govern billing.

Per the provider FAQ, call to check the status of a preauthorization request or to find out whether a procedure requires preauthorization. Workers' compensation: a claim number and the adjuster or injured-worker identification are usually required; coverage is determined by the claim (not by a member ID), and state fee schedules and rules govern billing.

Texas Mutual states it partners with Optum for injured-employee prescriptions; this is the number it publishes for Optum assistance (First Fill program available before a claim is filed). For prescribers and pharmacies helping a patient with a compensable injury. Workers' compensation: a claim number and the adjuster or injured-worker identification are usually required; coverage is determined by the claim (not by a member ID), and state fee schedules and rules govern billing.

Texas Mutual's WorkWell, TX healthcare network administration contacts as published on the provider page: network participation and network questions. Not for bill submission. Workers' compensation: a claim number and the adjuster or injured-worker identification are usually required; coverage is determined by the claim (not by a member ID), and state fee schedules and rules govern billing.