Texas Workers Compensation Health Care Network

Using the Network

The Workers Compensation Health Care Network is a program that Safeco is jointly delivering with Coventry Workers' Comp Services, a nationally recognized company that specializes in occupational health, disability management, and medical cost management. Coventry Workers' Comp Network comprises health care professionals who are part of Coventry's network of medical providers and facilities. Coventry Workers' Comp Network is easy to access and will assist injured workers in returning to work and to a healthy and a productive life. By utilizing this network for industrial injuries, you will be able to impact the medical direction of care on your Workers Compensation claims. With some exceptions, a claim that falls within the network will then have all medical treatment provided exclusively within the network.

Texas House Bill 7, which was enacted by the 79th Texas Legislature, authorized the establishment of Workers Compensation Health Care Networks. HB 7 provisions related to health care networks are codified in Insurance Code Chapter 1305.

The Coventry Workers' Comp Network is available in most areas of the state. The service area includes the greater Dallas, greater Houston, Austin/San Antonio, Amarillo, Central Texas, North East Texas, El Paso, Lubbock, Midland, Rio Grande Valley, Texarkana, Nacogdoches, Central East Texas, Abilene, Victoria, Corpus Christi, Orange, and Laredo, and Wichita Falls areas. The network cover 231 counties throughout the state.

Additional coverage areas may be added in the future. In order to determine if there is network coverage within a given ZIP code, use our Provider Search.

To utilize Coventry Workers' Comp Network, the law requires the following steps:

• First, you must notify Safeco that you wish to join the network. You can do this by obtaining a policy endorsement when you sign up for Workers Compensation coverage, or you may fill out an HCN Policyholder Election form [PDF] to opt-in to the network.
• You must notify each covered employee in writing about the use of the Health Care Provider Network. Safeco will provide you with Employee Information Materials in English or Spanish [PDF] to give to your current employees and new hires. This notification process is extremely important. If you do not follow it, you could lose the ability to direct medical care into the network.
• You must also have your employees sign an Employee Acknowledgment of Workers Compensation Network form [DOC]. You should keep these forms on file as proof that employees received the notification.
• You must document the method of delivery, to whom the notice was delivered, the location of the delivery, and the dates of delivery. You can distribute the notices directly to employees or mail the notices to their homes, as long as you document how you do it.
• When an employee is injured on the job, you MUST direct the injured employee to a network provider, unless emergency care is required. You will find information on medical providers in your Implementation Package.
• Clearly post information on the process in a location accessible to all employees.
• Clearly post the Coventry Workers' Comp Network Directory, which includes names of network providers.

At the time of injury, you must also do the following:

• Direct the injured employee to a medical provider within the Coventry Workers' Comp Network. This will most often be an occupational clinic or hospital (for more serious injuries). You can find these medical providers in the Medical Provider Directory. Injured employees can later change physicians within the network, but you should direct the first visit for medical treatment.
• Report the injury immediately by calling Safeco at (800) 332-3226.
• Provide the injured worker with a copy of the Employee Information Materials , [PDF] available in English or Spanish [PDF].
• Complete the Employer's First Report of Injury (DWC 1) [PDF].

The following materials will help you administer the Coventry Workers' Comp Network at your business.

Employee Information Materials [PDF] available in English or Spanish [PDF]	Distribute these materials to all employees, future employees, and employees who experience an injury in your workplace. These documents describe the Coventry Workers' Comp Network, benefits to the employee, and what the employee must do.
Employer Site Coordinator Guide [DOC]	Access all the information you need to know about administering claims using the Health Care Network.
Search for Medical Provider	Use this to locate providers within the Coventry Workers' Comp Network. You can also create and print custom provider directories and post notices for your workplace.
Employee Material Tracking Log [XLS]	Use this to keep track of materials you have distributed and signed by employees. You can use the electronic version to customize to your company's needs.

Note regarding the initial implementation of the Health Care Provider Network:
Be advised that the regulations governing these networks do require you, the employer, to take certain actions. Failure to meet the requirements may result in the inability to utilize the network. A complete Implementation Packet will be sent to all current policyholders. All new policies written in 2006 will have information about this program included in the Policyholder Claims Kit, which is sent to all new employers.

When you are notified of a work-related injury, please contact us at: (800) 332-3226.

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