DWC Announces Performance Based Oversight Results
Written by Editor   
Tuesday, March 19, 2019 12:00 PM

The Texas Department of Insurance, Division of Workers’ Compensation (DWC) has released the 2018 Insurance Carrier Performance Based Oversight (PBO) assessment. 

For 2018, insurance carriers were assessed on their performance for timeliness in the following categories:

  • paying initial temporary income benefits;
  • processing initial medical bills;
  • processing requests for reconsideration of medical bills;
  • submitting initial payment data by electronic data interchange (EDI); and
  • submitting medical bill processing data by EDI.

DWC reviewed 121 insurance carriers with the following results: 55 had scores placing them in the high performer tier, 65 were in the average performer tier, and one had a score placing them in the poor performer tier.

The 2018 PBO assessment results and a list of the insurance carriers that were reviewed are posted on the Texas Department of Insurance (TDI) website at: www.tdi.texas.gov/wc/pbo/pboresults.html. If an insurance carrier is not listed, it was not assessed in 2018; however, no insurance carrier in the Texas workers' compensation system is exempt from compliance with the Texas Labor Code and DWC rules.

More information on PBO and the 2018 assessment is available on the TDI website at www.tdi.texas.gov/wc/pbo/icpbo.html. DWC will assess health care providers separately in 2019.

Source:  https://www.tdi.texas.gov/news/2018/dwc12122018.html