Designation Of Administrative Services Company Administrator {DWC-120}

DWC120 - DESIGNATION OF ADMINISTRATIVE SERVICES COMPANY ADMINISTRATOR. Administrative services companies must use this form to designate up to three TXCOMP administrators to manage their system profile and the profiles for any designated doctors that have authorized the administrative services company to act as their agent. An administrative services company must file this form each time it adds or removes a TXCOMP administrator, including: • Newly hired and newly assigned administrators. • Administrators that are no longer employed or authorized to act as the company’s administrator. The company’s administrators and employees will continue to have the ability to change information on the company’s profile and the profiles of any designated doctors that have authorized the company to act as their agent until their access is removed. www.FormsWorkflow.com