Blackstone is a custom managed care provider panel that was formed by the City of Fort Worth to exercise the option to contract directly with health care providers for the provision of workers’ compensation medical benefits to their injured employees. The Blackstone provider panel represents an exclusive group of medical providers that excel in treating injured workers and in returning them to productive duty in a timely manner.
The Blackstone Manual sets forth the proposed operational guidelines and requirements applicable to the provider panel of Blackstone. It addresses specialized features applicable to provider under the Blackstone contract.
The Provider Manual is incorporated into the Blackstone Joinder Agreement and is binding on the provider panel. Among other matters, it sets forth the list of services requiring preauthorization, timelines for reconsiderations, applicable treatment guidelines, medical bill submission requirements, continuity of treatment guidelines, and the provider grievance process.
All participating providers will receive a copy of the Blackstone Provider Manual. If you are a member of the Blackstone provider panel and cannot locate the manual, contact us at email@example.com to obtain another copy.
Blackstone requires preauthorization for certain medical services. As such, the Blackstone Board has developed a comprehensive list of services that require preauthorization prior to obtaining the medical treatment. You can review this list via the following link:
List of Services requiring Preauthorization
In order to preauthorize a service, please contact a WellComp representative at:
Toll Free: 800-580-2273
The preauthorization request form can be accessed via the following link:
Preauthorization Request Form
Blackstone medical providers are expected to work with WellComp’s designated case managers in an effort to get the right care to the injured worker at the right time for the optimal outcome. Case managers will work closely with the treating physician and other providers, the injured worker’s supervisor, the workers’ compensation claims adjuster, and the injured worker to assure a successful return to work or alternate duty program where medically prudent.
If you would like to nominate a healthcare provider to be considered for inclusion on the exclusive Blackstone provider panel, please submit the following nomination form:
Provider Nomination Form
Please be advised that Blackstone maintains an exclusive panel of providers and may not have need for additional providers at this time.
You can contact us at firstname.lastname@example.org
While we maintain a limited provider panel, from time-to-time our member employers need additional providers in their geographic region. See the Provider Nomination section to the right hand side of this page for more info.
As a provider of workers’ compensation medical services in Texas you may be required to submit medical bills using the eBill process. You can submit medical bills to the following address:
Direct all billing inquiries to the following:
York Risk Services Group, Inc.
Address: P.O. Box 26655 Austin, TX 78755-0655
Yes, unless you get permission from the workers’ compensation adjuster at York Risk Services Group to refer to a non-participating provider. This can happen if the injured worker needs specialty care that is not contracted with Blackstone or if other special needs exist.
You can access the Blackstone provider panel using the Provider Lookup links on this website.
If you need to submit a request for consideration of a non-participating provider, please contact the workers’ compensation adjuster at 800-580-5477.
You can review this list by selecting this link: