Tex. Ins. Code § 843.341 · Subchapter J. PAYMENT OF CLAIMS TO PHYSICIANS AND PROVIDERS
CLAIMS PROCESSING PROCEDURES.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) A health maintenance organization shall provide a participating physician or provider with copies of all applicable utilization review policies and claim processing policies or procedures.
(b) A health maintenance organization's claims payment processes shall:
(1) use nationally recognized, generally accepted Current Procedural Terminology codes, notes, and guidelines, including all relevant modifiers; and
(2) be consistent with nationally recognized, generally accepted bundling edits and logic.
Notes and commentary — not statutory text
History
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003. Amended by Acts 2003, 78th Leg., ch. 214, Sec. 13, eff. June 17, 2003.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.843.htm
- Text hash
- sha256 1280653f267e8df22070643e014b7283a211345a6d6b2498cb716d60facb3120
- 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
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.