6 TIC §843.255(c)
August 8, 2021 3:13 pm(c) The physicians or other providers on a complaint appeal panel must have experience in the area of care that... View more
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6 TIC §843.259(a-b)
August 8, 2021 3:37 am(a) A health maintenance organization shall include in a notice of the final decision on an appeal a statement of... View more
6 TIC §843.338
August 8, 2021 1:09 amExcept as provided by Sections 843.3385 and 843.339, not later than the 45th day after the date on which a... View more
6 TIC §843.342(a-b)
August 8, 2021 1:19 am(a) …the health maintenance organization shall pay the physician or provider making the claim the contracted rate owed on the... View more
6 TIC §843.342(a-c)
August 15, 2021 9:59 am(a) Except as provided by this section, if a clean claim submitted to a health maintenance organization is payable and... View more
6 TIC §843.342(c)
August 8, 2021 1:22 am…the health maintenance organization shall pay a penalty computed under Subsection (b) plus 18 percent annual interest on that amount.... View more
6 TIC §843.348(d)
August 8, 2021 9:34 am(d) On receipt of a request from a participating physician or provider for preauthorization, the health maintenance organization shall review... View more
6 TIC §843.348(g)
August 8, 2021 2:56 am(g) If the health maintenance organization has preauthorized health care services, the health maintenance organization may not deny or reduce... View more
6 TIC §843.350(a-b)
August 17, 2021 5:24 pm(a) A health maintenance organization may recover an overpayment to a physician or provider if: (1) not later than the... View more
6 TIC §843.350(a)(1-2)
August 8, 2021 3:10 am(a) A health maintenance organization may recover an overpayment to a physician or provider if: (1) not later than the... View more