3 best practices for your workers' comp patients' pharmacy needs

As a WorkWell, TX health care network provider, you play an important role in helping your patients get the care and treatment they need to help them return to a productive life after a work-related injury. We recommend these three best practices to connect your workers’ comp patients with the right pharmacy:

Use Locate Network Provider tool: Texas Mutual partners with Optum to fill prescriptions for covered on-the-job injuries or illnesses. Participating Optum pharmacies include Walgreens, CVS, Walmart, Kroger, Target, Costco, Sam's Club, Brookshire, HEB and Tom Thumb. Both physicians and patients can use this online tool to search for network pharmacies nearby. If you need assistance from Optum, call (888) 220-2805.
Share First Fill form with patients: Patients can present a First Fill form (English PDF, Spanish PDF) at a participating Optum pharmacy to get a seven-day supply for each covered prescription with a maximum of $500 per prescription. The form is valid only for the first fill and cannot be used if the first prescription fill is being requested more than 10 days after the injury occurred.
Review pharmacy regulations: Those who prescribe medication for the treatment of injured workers should be familiar with the latest pharmacy regulations from the Texas Department of Insurance. You can find this information and more on the provider page on the Texas Mutual website.

Verify patient coverage with our online tool

With our online tool, you can check coverage information online three days after an injury has been reported. Simply enter your provider tax ID or FEIN, and either the claim number or the patient’s social security number and date of injury. You’ll find claim status, EOBs and claim info.

CHECK PATIENT COVERAGE

Online page and resources just for providers

The provider page on the Texas Mutual website is your go-to resource for all your network needs. Find the most commonly used tools like requesting preauthorization, checking claim status, verifying patient coverage, FAQs and more.

EXPLORE PROVIDER PAGE

This newsletter is exclusively for the WorkWell, TX provider community, brought to you by Texas Mutual Insurance Company. We'll be sharing resources and insights that make it easier to do business with us and helps you better serve your workers' compensation patients.

Helpful resources

Email network administration for out-of-network approval and help finding providers

Email provider relations for contract questions, billing and general inquiries

Find links to check claim status or EOB, verify coverage or find network information

View a preauthorization list and get details on how to submit preauth requests

We are committed to helping you provide exceptional care.

(844) 867-2338