Tex. Insurance Code § 843.341
This is the official text of Tex. Insurance Code § 843.341, part of Texas’s Insurance Code — regulates insurance companies and the policies they sell.
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§ 843.341. CLAIMS PROCESSING PROCEDURES.
Official statutory text
(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.
(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.
Status: in_force · Read it on the official government site
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