Tex. Insurance Code § 843.254
This is the official text of Tex. Insurance Code § 843.254, part of Texas’s Insurance Code — regulates insurance companies and the policies they sell.
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§ 843.254. APPEAL TO COMPLAINT APPEAL PANEL; DEADLINES.
Official statutory text
(a) A health maintenance organization shall provide an appeals process for a complainant who is not satisfied with the resolution of the complaint. The appeals process must include the right of the complainant to:
(1) appear in person before a complaint appeal panel at the site at which the enrollee normally receives health care services or at another site agreed to by the complainant; or
(2) address a written appeal to the complaint appeal panel.
(b) The health maintenance organization shall send an acknowledgment letter to the complainant not later than the fifth business day after the date the written request for appeal is received.
(c) The health maintenance organization shall complete the appeals process not later than the 30th calendar day after the date the written request for appeal is received.
(1) appear in person before a complaint appeal panel at the site at which the enrollee normally receives health care services or at another site agreed to by the complainant; or
(2) address a written appeal to the complaint appeal panel.
(b) The health maintenance organization shall send an acknowledgment letter to the complainant not later than the fifth business day after the date the written request for appeal is received.
(c) The health maintenance organization shall complete the appeals process not later than the 30th calendar day after the date the written request for appeal is received.
Status: in_force · Read it on the official government site
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