Sec. 1305.403. RECORD OF COMPLAINTS. (a) Each network shall maintain a complaint and appeal log regarding each complaint. The commissioner shall adopt rules designating the classification of network complaints under this section.
(b) Each network shall maintain a record of and documentation on each complaint, complaint proceeding, and action taken on the complaint until the third anniversary of the date the complaint was received.
(c) A complainant is entitled to a copy of the network's record regarding the complaint and any proceeding relating to that complaint.
(d) The department, during any investigation or examination of a network, may review documentation maintained under this subchapter, including original documentation, regarding a complaint and action taken on the complaint.
Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 4.02, eff. September 1, 2005.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Chapter 1305 - Workers' Compensation Health Care Networks
Subchapter I. Complaint Resolution
Section 1305.401. Complaint System Required
Section 1305.402. Complaint Initiation and Initial Response; Deadlines for Response and Resolution
Section 1305.403. Record of Complaints
Section 1305.404. Retaliatory Action Prohibited
Section 1305.405. Posting of Information on Complaint Process Required