Sec. 1301.1051. COMPLETION OF AUDIT. The insurer must complete an audit under Section 1301.105 on or before the 180th day after the date the clean claim is received by the insurer, and any additional payment due a preferred provider or any refund due the insurer shall be made not later than the 30th day after the completion of the audit.
Amended by:
Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.037(a), eff. September 1, 2005.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Chapter 1301 - Preferred Provider Benefit Plans
Subchapter C. Prompt Payment of Claims
Section 1301.102. Submission of Claim
Section 1301.1021. Receipt of Claim
Section 1301.103. Deadline for Action on Clean Claims
Section 1301.104. Deadline for Action on Pharmacy Claims; Payment
Section 1301.105. Audited Claims
Section 1301.1051. Completion of Audit
Section 1301.1052. Preferred Provider Appeal After Audit
Section 1301.1053. Deadlines Not Extended
Section 1301.1054. Requests for Additional Information
Section 1301.106. Claims Processing Procedures and Claims Payment Processes
Section 1301.107. Contractual Waiver and Other Actions Prohibited
Section 1301.108. Attorney's Fees
Section 1301.109. Applicability to Entities Contracting With Insurer