Health Care Network Information for TX Policyholders*
As your insurance carrier, Berkshire Hathaway GUARD Insurance Companies have chosen Coventry to offer a workers' compensation health care provider network certified by the state of Texas. The necessary materials to implement the program are provided below, including the instructions to help prepare you when an injury occurs.
Components of Program:
- Preferred provider network
- Employee educational materials
- Toll-free first report of injury
- Utilization management (pre-authorization)
- Telephonic and on-site case management (may include vocational services)
- Complaint process
- Read the network educational materials and post the Network Notice.
- Download and distribute hard copies of the Coventry Workers’ Comp Network Employee Information Materials (available in English and Spanish) when initiating the program, within three days of hiring an employee, and at the time of injury. Document the method of delivery of educational materials, to whom the materials were delivered, the location of the delivery, and the date delivered.
- Be sure that all employees sign the Employee Acknowledgement and keep a copy in the employee’s personnel file. An employee who refuses to sign remains subject to network requirements, but the refusal should be documented in the employee’s personnel file.
- Review the On-line Directory of Managed Care Providers to ensure that the suggested medical providers are within the geographical service area of the worksite. You may call Coventry at 1-800-243-2336 for additional doctors.
- When an injury occurs, report the incident immediately by calling 1-888-NEW-CLMS (1-888-639-2567) and provide the employee with a copy of the Provider Instruction Form. If necessary, provide or arrange transportation of the injured employee to the network provider, or if appropriate, to the nearest emergency facility.
If you have any questions, don’t hesitate to call Berkshire Hathaway GUARD’s Customer Service Department at 1-800-673-2465.
*This information is intended for policyholders utilizing a health care network; in such cases, a letter describing needed information and resources (similar to this page) is included with the policy package.