Texas Mutual offers healthcare providers a robust platform designed to streamline workers’ compensation claims management, billing, and patient care coordination. This comprehensive resource supports healthcare professionals in delivering efficient, focused care for workplace injury patients.
Official Links
- Primary Website: Texas Mutual Providers
- Main Website: Texas Mutual
What Providers Can Do
Healthcare providers working with Texas Mutual can:
- Verify patient coverage
- Check claim status
- Submit electronic bills
- Access provider training videos
- Complete necessary forms
- Communicate patient work status
- Request pre-authorization for treatments
Provider Network Details
Texas Mutual operates the WorkWell, TX health care network, which focuses on:
- High-quality, recovery-oriented providers
- Specialized workers’ compensation care
- Network provider nomination process
Key Operational Steps
Coverage Verification
- Use Texas Department of Insurance coverage verification tool
- Call (888) 532-5246 to confirm network participation
Patient Treatment Process
- Provide return-to-work focused care
- Complete required documentation (DWC Form-73)
- Submit bills electronically to Jopari Solutions (Payer ID: 22945)
Billing Requirements
Electronic Billing Mandates
- Most providers must submit bills electronically
- Submit within 95 days of service
- Complete all required fields on:
- CMS-1500 for physician services
- UB-04 for facility charges
- DWC-66 for pharmacy services
Pharmacy Benefits
Texas Mutual partners with Optum to manage prescription needs:
- First Fill program allows seven-day medication supply
- Call (888) 220-2805 for pharmacy assistance
- Follow Texas Department of Insurance pharmacy regulations
Pre-Authorization Process
How to Request
- Complete pre-authorization request form
- Attach medical documentation
- Email to [email protected]
Support Contacts
Quick Reference
- Claims & Billing: (888) 532-5246
- Network Administration: (844) 867-2338
- Preauthorization: (800) 844-4235
- Pharmacy Benefits: (833) 486-7886
Privacy and Security
While specific portal security details aren’t explicitly outlined in the provided documentation, Texas Mutual emphasizes compliance with healthcare information management standards.
Unprovided Information
The sources do not provide:
- Specific login credentials
- Detailed mobile app information
- Comprehensive portal feature list
Professional Resources
Providers can access:
- Network provider manual
- Training videos
- Workplace diagnosis resources
- Office visit strategy materials
Texas Mutual’s provider resources demonstrate a commitment to supporting healthcare professionals in delivering effective workers’ compensation care. By offering comprehensive tools, training, and support, they facilitate streamlined patient treatment and claims management.
Note: All information is current as of the 2025 documentation from Texas Mutual’s website.
FAQ
What kind of insurance is Texas Mutual?The company provides a stable, competitive source of workers’ compensation insurance for Texas employers, acts as the insurer of last resort, and helps to prevent on-the-job injuries and illnesses and minimizes their consequences.
What is the payer ID for Texas Mutual?Bills for Texas Mutual should be submitted to Jopari Solutions (payer ID: 22945).
Who is the parent company of Texas Mutual Insurance Company?As a mutual insurance company, Texas Mutual is solely owned by its policyholders.
How much do adjusters make at Texas Mutual?The average Claims Adjuster base salary at Texas Mutual Insurance Company is $66K per year.
https://www.texasmutual.com/providers/
We’re here to help you succeed. Find out about our health care network, pharmacy benefits, billing, forms and contact information.
https://www.texasmutual.com/
Help us build a stronger, safer Texas. See how to get started with Texas Mutual and what to expect with your workers’ compensation coverage.