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Texas D.O. Online
April 2000

NHIC Postpones New Medicaid Claims Processing System

Implementation of Compass 21, the new Medicaid claims processing system, originally scheduled for May 1, 2000, has been postponed by the National Heritage Insurance Company (NHIC), administrator of the Medicaid program. Physicians who participate in the Medicaid program should continue using the current system until further notice.

Sherry Travis, Director of Provider Services and Compass 21 Provider Transition, stated in a letter to TOMA that NHIC decided on the delay because of the results of tests of the system "dictate that we change the implementation date to allow more time to ensure a quality system is implemented." Testing and technical refinements of the system are continuing and a new implementation date is expected to be set in the next few weeks.

For more information, call the NHIC customer service line at (800) 925-9126 or the Compass 21 hotline at (512) 514-3689.

TWCC Puts Form TWCC-73 on Hold

Because of lobbying efforts by TOMA and other Texas health care organizations, the Texas Workers' Compensation Commission (TWCC) has delayed requiring physicians to use the TWCC-73 work status report form until further notice.

In late March, a TWCC Advisory stated that because of pending revisions to the form and the rules relating to its use, the commission will not require doctors to use the TWCC-73 form or meet the turnaround time of one (1) working day from the date of examination. Terry Boucher, TOMA Executive Director and Joseph Montgomery-Davis, D.O., TOMA representative to the TWCC Medical Advisory Committee, pointed out to the TWCC, the tremendous burden that the original proposal would place on osteopathic physicians. TWCC had planned to require physicians who examine injured workers to determine their fitness to return to work. Then, the physician would have to fax or electronically send the form to the injured worker's TWCC insurance carrier and to the worker's employer within one (1) day after the initial examination, after each following exam (required once every 2 weeks) and again when the worker's work status changed.

The TWCC advisory stated that a revised form and new rules extending the time for physicians to file the form are being considered. The TWCC seeks input from physicians on the use of Form 73 and the regulations that govern its use. A draft form is available on the TWCC website - www.twcc.state.tx.us - under the "Forms" section.

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