1. (a) Submitting bills for payment. The health care provider shall submit all medical bills to the insurance carrier. The provider may elect to submit bills to an employer who has indicated a willingness to pay them. If the employer is billed, a copy of the bill submitted to the carrier shall state the following in bold type: "THIS IS ONLY AN INFORMATION COPY, IT IS NOT A REQUEST FOR PAYMENT."

2. (b) Waiver of rights. A provider who elects to submit bills to an employer waives, for the duration of the election period, the rights to:

   1. (1) prompt payment, as provided by the Texas Workers' Compensation Commission Act (the Act), Article 8308-4.68;
   2. (2) interest for delayed payment as provided by the Act, Article 8308-8.27; and
   3. (3) commission-provided medical dispute resolution as provided by the Act, Article 8308-8.26.
3. (c) Time for submission--health care practitioners. Health care practitioners (as defined in the Act, §1.03(22)) shall submit to the carrier a properly completed bill within 15 days after the initial service or treatment date. Subsequent billing shall be at least monthly for services and treatments rendered.
4. (d) Time for submission--health care facilities. For inpatient services, health care facilities (as defined in the Act, §1.03(21)) shall submit bills to the insurance carrier within 10 days after discharge, if the confinement is 30 days or less. If the confinement is greater than 30 days, the facilities shall submit an interim bill within 45 days of admission and then at least every 30 days until discharge. The final bill shall be submitted within 10 days of discharge. For outpatient services, bills shall be submitted at least monthly to the insurance carrier.
5. (e) Providing information copies of bills. Upon request the provider shall send, at no cost, a copy of the bill, as submitted for payment, to the employee, the employee's representative, or the commission. Upon request the provider shall also submit a copy of the bill, as submitted for payment to the employer, and may charge the employer the fee for copies of reports as described in §133.106(f)(3) of this title (relating to Fair and Reasonable Fees for Required Reports and Records). Information copies shall state the following in bold type: "THIS IS ONLY AN INFORMATION COPY, IT IS NOT A REQUEST FOR PAYMENT."

Source Note:The provisions of this §134.801 adopted to be effective February 20, 1991, 16 TexReg 671; amended to be effective June 1, 1992, 17 TexReg 3250.