Frequently Asked Questions

A health care network is an organization certified by the Texas Department of Insurance and under contract with an insurance carrier to deliver health care to injured workers.

• Networks control costs by contracting with health care providers to perform health services at pre-negotiated rates below Texas State Fee Schedule. Employers who complete the enrollment process as required by Texas workers’ compensation statutes are eligible for a premium reduction.
• Networks are required to offer an adequate number of providers per state-certified geographic service area to ensure appropriate access to medical care.
• With the use of return-to-work guidelines chosen by the network, the employee’s medical progress can be monitored as well as their ability to return to the job.
• The use of a treating provider as a gatekeeper helps closely supervise patient care and progress under treatment.
• Physicians are required to work with case managers to help facilitate treatment for injured workers.
• A quality improvement program is in place to continuously evaluate the network’s overall effectiveness and ensure continuous improvement.

Most eligible policyholders will receive an annual network premium discount of 10 percent. For mid-term endorsements, the 10 percent is prorated for the remainder of the policy term. The network discount is only applicable to Texas premium.

Yes, eligible accounts can opt into the network during the policy period, and the discount will be applied pro-rata. Contact your agent for assistance.

Yes, you must complete the enrollment process to participate in Acuity’s health care network.

Following the completion of the steps outlined in our Enrollment Checklist & Instructions document located at acuity.com/TexasHCN, fill out and send to Acuity the Attestation Form also on our website.

No, once the notice has been distributed and the acknowledgment form is signed, the network requirements remain in place as long as the policyholder stays with Acuity. However, a second acknowledgment form is required when an injury occurs.

The employer should keep records of the distribution, method of delivery, date of delivery, and any refusals to sign the form. An employee who receives the employee notice but refuses to sign the acknowledgment form is subject to network requirements, unless the employee has pre-designated his/her HMO treating doctor. Pre-designation must be done directly with the network prior to injury. An injured employee who seeks care outside the network and has not pre-designated his/her HMO treating doctor, may be financially responsible for his/her medical costs.

A list of network providers is available at corvel.com/ppo-lookup/. From the website, choose the ‘Texas CorCare Certified Network’. You may also email Texas@corvel.com, or call CorVel at 866.353.9768.

Each network determines what specialties are included as treating physicians. CorVel’s current network does not include physical therapists, occupational therapists, or chiropractors as treating physicians.

Employer compliance will be examined on a case-by-case basis. Acuity will work with policyholders to ensure they understand their responsibilities and are fully informed. The Texas Health Care Network Endorsement allows Acuity to remove the credit for making the network election if the employer does not comply with their responsibilities.

You will be able to opt out of the network mid-term. Fill out and send to Acuity the HCN Enrollment Termination Form located at acuity.com/TexasHCN.

CorVel has a strategic advantage by owning their own contracts and building relationships with providers directly. CorVel’s Texas Health Care Network program has a state required Annual Work plan that is overseen by the Texas Department of Insurance (TDI) to ensure all providers are properly being evaluated and credentialed on a continuous basis. All providers may be nominated to the network for consideration. The network’s Quality Improvement Program Committee (QIPC) will review the provider before executing a contract with the provider/group.

CorVel’s Texas HCN program has a state certified resolution process to review complaints within a timely fashion as required in the Texas Admin Code Chapter 1305.

All claims prior to the HCN effective date will need to get network approval before enrolling into the HCN.