Texas

Voluntary/Informal Pharmacy Network

Tmesys

Pursuant to Texas Voluntary/Informal Pharmacy Network notification requirements – Texas Labor Code 408.0281(d) – this website contains information pertaining to the clients (carriers, third-party administrators, and self-insured employers) who have contractual arrangements to access the Tmesys pharmacy network for the provision of pharmacy services at rates inconsistent with the Texas workers’ compensation pharmacy fee guidelines.

Pharmacy transactions processed through our networks are submitted directly to Tmesys and are paid directly by Tmesys to the provider at the specific rates established in the contract between Tmesys and the provider. Tmesys does not sell, lease, transfer, or convey its specific contractual fee arrangement rates with network providers to any other entity. 

As a pharmacy provider within the Tmesys Texas network, initial notification of this web address and associated information would have been provided to you, and revised communications and updates will be sent on an as needed basis as required by the law. Tmesys will update required compliance information posted on this website, and we urge you to refer to this information frequently.

Should you have any additional questions concerning this information, please contact:

​Tmesys Retail Pharmacy Operations
Contact: Doug Radant
175 Kelsey Lane
Tampa, FL 33619 
​1.877.275.7674

For additional information regarding entities that are contracted with, or have access to, the Tmesys pharmacy network, please view our Access List

Home ​Health and Durable Medical Equipment

Pursuant to Texas Labor Code § 408.0284, et seq., please find this web page as our notice to Texas Providers about our workers’ compensation informal network for home health and durable medical equipment (DME) in the state of Texas, as required under the code section(s).

Should you have any additional questions concerning this information, please contact:

Optum Workers’ Compensation Services of Georgia
2736 Meadow Church Road NW, Suite 300
Duluth, Georgia 30097
800.419.7191 Ext. 7043 or 7289
txnotification@healthcaresolutions.com

For a list of entities with access to our home health and DME informal provider network in Texas, please view our Access List. 


Third-party ​Administrator

Pursuant to specific direction from the Texas Department of Insurance (TDI), ​Optum has been licensed as an “administrator” as that term is specifically defined under Texas Insurance Code Section 4151.001. This designation requires certain compliance steps to be taken by both ​Optum and our clients, including but not limited to the following:

  • Written agreements between ​Optum and our carrier, self-insured employer, and third-party administrator clients
  • Semi-annual reviews and bi-annual on-site audits of Helios by our carrier and self-insured employer clients for which ​Optum, in the aggregate, administers benefits in Texas for more than 100 injured employees
  • Notice to each insured/injured employee of Helios' identity and relationship between ​Optum, client, and insured/injured employee
  • Compliance with proper notification and other reporting requirements to TDI by ​Optum

The following are links to additional relevant information pertaining to compliance requirements: