Workers' Compensation Billing Information for Providers

For complete, current billing instructions for health care providers and hospitals, see TDI's Clean Claim Electronic Medical Billing and Payment Workers' Compensation Guide.

Electronic billing

Healthcare providers are required to submit bills electronically. The Fund contracts with Jopari Solutions Inc. to assist in streamlining medical bill processing. Benefits of this arrangement include:

  • Helping ensure compliance with eBill regulations

  • Getting cleaner data to Fund bill review for processing

  • Eliminating manual processes

  • Reducing mail and response time 

  • Allowing providers to submit attachments with their electronic bills

To contact Jopari for assistance, call 866.269.0554 or visit the Jopari Web site.

For information about electronic billing rules, visit the Texas Department of Insurance (TDI) e-Bill page.

Traditional billing

Submit completed medical bills to:
TASB Risk Management Fund
P.O. Box 2010
Austin, TX 78768

Billing tips

Use the proper DWC billing forms and complete all required fields accurately:

  • CMS-1500 for physician services and ambulatory surgical services (using the instructions on the DWC-67)

  • UB-04 for facility charges, including hospital, inpatient and outpatient services, and home health services (using the instructions on the DWC-68)

  • DWC-66 for pharmacy services (form includes instructions)

  • Make sure the bill is complete per DWC Rule 133.1.

    • Check DWC Rule 133.210 for documentation requirements.

    • Submit bills within 95 days of the date of service.

    • Provide a valid state medical license number and NPI number.

    • Provide valid diagnosis codes (ICD-9 codes).

    • Provide valid procedure codes (CPT codes).

    • Provide valid NABP and FID numbers.

    • Include modifiers for procedure codes when required.

    • Include a physical address in Box 32 for ambulance bills.

Checking bill status

Call 800.482.7276 to check medical bill payment status. You will need the following information:

  • Injured worker's Social Security number or claim number

  • Health care provider FEIN

  • Date of service