Health care providers play an important role in the workers' compensation system. You deliver quality care for Texas' injured workers and help them return to productive employment. Ultimately, that is what is best for workers, their employers and their families.
Texas Mutual Insurance Company wants to help you streamline your job as much as possible. Our website makes it easy for you to:
Please feel free to email us or call us at (800) 859-5995 with questions, concerns or suggestions on how we can improve our service to you.
- Claim mailing address:
P.O. Box 12029, Austin, Texas 78711-2029
- Preauthorization fax: (800) 852-1805
- Preauthorization phone: (888) 53-CLAIM (532-5246)
- Fax a bill: (512) 224-3889
- Claim information phone: (888) 53-CLAIM (532-5246)
- Electronic billing (Jopari Solutions): (866) 269-0554
- Cypress Care, our pharmacy benefit manager: cypresscare.com, (888) 220-2805
Texas Mutual has transitioned to ICD-10Starting October 1, outpatient and professional bills with a date of service on or after October 1, 2015 are only accepted if they contain valid ICD-10 codes. Inpatient coding requires the use of both the ICD-10 diagnosis codes (ICD-10-CM) and procedure codes (ICD-10-PCS) when the discharge date is on or after October 1, 2015. ICD-9 codes are not accepted for dates of service after September 30, 2015. Medical bills that contain both ICD-9 and ICD-10 codes are not accepted.
State adopts pharmacy closed formularyThe Texas Department of Insurance, Division of Workers' Compensation (DWC) has adopted a pharmacy closed formulary for claims occurring on or after September 1, 2011. The formulary is intended to facilitate drug-prescribing consistency between network and non-network claims. DWC has posted the entire list of "N" drugs as published by Official Disability Guidelines (ODG) in Appendix A on its website, free of charge.
Need information about Texas Mutual's certified health care network?
Visit the latest issue of Comp at Work, the newsletter for Texas Star Network® providers.