Tenn. Comp. R. & Regs. 0800-02-30-.09 - PAYMENTS FROM THE FUND
(1) Annually the
Bureau shall contract with a Third-Party Claim Administrator to administer UEF
claims. The Third-Party Claim Administrator shall request, receive, and review
medical records and medical bills and shall submit recommendations to pay
temporary disability benefits and medical benefits from the Fund, including
attorney fees, via a voucher to the Claim Administrator. The payment of
benefits is contingent upon the review and approval by the Bureau Administrator
of the Third-Party Administrator's recommendations.
(2) Payments for temporary disability
benefits and medical benefits shall not be issued unless the Bureau has on
file: IRS form W-9 "Request for Taxpayer Identification Number and
Certification" for the employee and attorney, if applicable; an expedited or
compensation hearing order; and a report from the Claim Administrator
recommending payment to medical providers, payment of temporary disability
benefits to injured workers, or payment of attorney's fees, and child support
liens.
(3) The Bureau shall
establish that the injured worker, the injured worker's attorney, if
applicable, and each medical provider is a vendor in the state system for
payments.
(4) The UEF benefit
coordinator shall maintain in the Bureau's computer system financial records to
document payments for contract services, total medical payments made per each
injured worker, total disability benefits, monthly benefit payments and
payments per fiscal year.
(5) Any
costs associated with a Third-Party Administrator, along with any other
administrative costs, shall be paid from the Fund.
(6) All medical bills for services rendered
must be submitted within one year of the date of service to the Bureau of
Workers' Compensation, Suite 1-B, 220 French Landing Drive, Nashville,
Tennessee 37243.
Notes
Authority: T.C.A. ยงยง 50-6-801, 50-6-802, and 50-6-803.
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