Political Subdivision Workers Compensation Alliance

Providers

Your questions answered.

Provider FAQs


How can I find out if I am contracted with the Alliance?

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If this tax ID is associated with a contracted practice, you will either see a list of providers that are contracted or a list of practice locations that are contracted. If a list of practice locations appears, then all providers with this practice are contracted. If there is a list of providers and your name does not appear, you are not a contracted provider. Please apply to become a provider by completing a Provider Application.

I am certain that I am not an Alliance contracted provider, but I wish to treat an injured worker. What do I do?

Exceptions for non-contracted providers are rare. To request an exception you need to gain authorization from the assigned adjuster. Contact information for our risk pools can be found here.

I know our practice is contracted, but I need to know which providers are currently contracted.

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These are the providers who are currently contracted and able to treat Alliance injured workers. If you need to remove providers or update practice locations, you will need to complete an Exhibit C (Excel file) and return to us. To add providers, you will need to submit a Provider Application Form. We will respond within 45 days with a determination.

How long does it take to become a provider after I return the contract and credentialing documents?

The turnaround time to process a contract and new provider credentialing documentation is approximately 6 weeks.

Where do I send billing?

Do NOT send any medical bills to the Alliance office. Medical bills should be sent to the Responsible Pool. If you don’t already know which pool is the Responsible Pool, you can usually figure it out based on the employer.

If the employer is a… the Responsible Pool is usually… Phone Number Mailing Address
School District TASB RMF 800-482-7276 PO Box 2010, Austin TX 78768-2010
City TML IRP 800-537-6655 PO Box 149194, Austin TX 78714-9194
County TAC RMP 800-752-6301 P.O. Box 160120, Austin, TX 78716
Community Center TCRMF 800-580-6467 PO Box 26655, Austin TX 78755-0655
Water Districts and Authorities TWCARMF 800-580-8922 PO Box 26655, Austin TX 78755-0655
Other entities (appraisal districts, emergency service districts, hospital districts, etc.) please call the employer to verify which pool is providing coverage.

How do I sign up for E-Billing?

E-Billing is highly encouraged, and may be required by law depending on the size of your practice and volume of claims. Details regarding Labor Code 133.501 703 can be found here. Below are the E-Billing providers for the pools:

Texas Association of School Boards Risk Management Fund

Texas Association of School Boards Risk Management Fund
Jopari Solutions Inc. eBill
Toll Free: 866-269-0544
Enroll online at Jopari.com

 
Texas Municipal League Intergovernmental Risk Pool

Texas Municipal League Intergovernmental Risk Pool
Jopari Solutions Inc. eBill
Toll Free: 866-269-0544
Enroll online at Jopari.com

 
Texas Association of Counties Risk Management Pool

Texas Association of Counties Risk Management Pool
Work Comp EDI
Toll Free: 800-297-6909
Email: info@workcompedi.com
Payer ID: WK006

 
Texas Water Conservation Association Risk Management Fund

Texas Water Conservation Association Risk Management Fund
Work Comp EDI
Toll Free: 800-297-6909
Email: info@workcompedi.com
Payer ID: WK006

 
Texas Council Risk Management Fund

Texas Council Risk Management Fund
Work Comp EDI
Toll Free: 800-297-6909
Email: info@workcompedi.com
Payer ID: WK006

 

If you do not utilize E-Billing, mailing addresses for our pools can be found here.

Who do I call for claims payment status?

To inquire about the status of a claim payment, contact the Responsible Pool. The Alliance does NOT handle the claims payments. If you don’t already know which pool is the Responsible Pool, you can usually figure it out based on the employer.

If the employer is a… the Responsible Pool is usually… Phone Number Mailing Address
School District TASB RMF 800-482-7276 PO Box 2010, Austin TX 78768-2010
City TML IRP 800-537-6655 PO Box 149194, Austin TX 78714-9194
County TAC RMP 800-752-6301 P.O. Box 160120, Austin, TX 78716
Community Center TCRMF 800-580-6467 PO Box 26655, Austin TX 78755-0655
Water Districts and Authorities TWCARMF 800-580-8922 PO Box 26655, Austin TX 78755-0655
Other entities (appraisal districts, emergency service districts, hospital districts, etc.) please call the employer to verify which pool is providing coverage.

Do I have to refer to an in-network provider?

Yes, you must refer to an in-network specialist unless there are no options in your area. If you would like to refer to an out-of-network provider, you may request an exception from the adjuster. If you would like to nominate a provider that you prefer to refer patients to, you can complete a Provider Application form.

I'm not certain if the procedure we're planning requires preauthorization. Where can I find that information?

The list of procedures that require preauthorization can be found in Appendix A of our Provider Manual (pg. 31). Preauthorization forms are located both in the Provider Manual and on the Resources page of our site.

The Political Subdivision Workers' Compensation Alliance (the Alliance) is a 504 network serving 5 public entity risk pools: