Tex. Ins. Code § 1301.102 · Subchapter C. PROMPT PAYMENT OF CLAIMS
SUBMISSION OF CLAIM.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) A physician or health care provider must submit a claim to an insurer not later than the 95th day after the date the physician or provider provides the medical care or health care services for which the claim is made.
(b) Except as provided by Chapter 1213, a physician or health care provider may, as appropriate:
(1) mail a claim by United States mail, first class, or by overnight delivery service;
(2) submit the claim electronically;
(3) fax the claim; or
(4) hand deliver the claim.
(c) An insurer shall accept as proof of timely filing a claim filed in compliance with Subsection (b) or information from another insurer or health maintenance organization showing that the physician or health care provider submitted the claim to the insurer or health maintenance organization in compliance with Subsection (b).
(d) If a physician or health care provider fails to submit a claim in compliance with this section, the physician or provider forfeits the right to payment.
(e) The period for submitting a claim under this section may be extended by:
(1) contract;
(2) notice published by the commissioner allowing an extension of prompt payment deadlines to a later date chosen by the commissioner due to a catastrophic event; or
(3) the department's approval of a physician's or health care provider's request for an extension due to a catastrophic event that substantially interferes with the normal business operations of the physician or provider.
(e-1) The commissioner may adopt rules to implement Subsection (e), including rules establishing requirements for a request made under Subsection (e)(3).
(f) A physician or health care provider may not submit a duplicate claim for payment before the 46th day after the date the original claim was submitted. The commissioner shall adopt rules under which an insurer may determine whether a claim is a duplicate claim.
Notes and commentary — not statutory text
History
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Amended by:
Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.037(a), eff. September 1, 2005.
Acts 2023, 88th Leg., R.S., Ch. 90 (S.B. 1286), Sec. 3, eff. September 1, 2023.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1301.htm
- Text hash
- sha256 e0c28dd4d58bf5fa82ec091819a4b3744e4d93d0593e1497c2a388d943e7fffd
- Composed by
- compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character
This section cites
Provisions in this library that the text above cites, as it prints each citation. A range cited as “ss. 61.13-61.16” links its first and last provisions.
Cited by 3 provisions
Provisions in this library whose text cites Tex. Ins. Code § 1301.102. Each shows the citation as that text prints it.
Insurance Code
- Tex. Ins. Code § 1301.1054REQUESTS FOR ADDITIONAL INFORMATION.Printed as Sections 1301.102(b) and 1301.1021
- Tex. Ins. Code § 1301.107CONTRACTUAL WAIVER AND OTHER ACTIONS PROHIBITED.Printed as Section 1301.102(e)
- Tex. Ins. Code § 1369.260CLERICAL OR RECORDKEEPING ERROR; FRAUD ALLEGATION.Printed as Section 843.337 or 1301.102
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.