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    • Legislation USA
    • Texas Statutes
    • Insurance Code
    • Title 14 - Utilization Review and Independent Review
    • Chapter 4201 - Utilization Review Agents
    • Subchapter H. Appeal of Adverse Determination
    • Section 4201.351. Complaint as Appeal

    Texas Statutes
    Subchapter H. Appeal of Adverse Determination
    Section 4201.351. Complaint as Appeal

    Sec. 4201.351. COMPLAINT AS APPEAL. For purposes of this subchapter, a complaint filed concerning dissatisfaction or disagreement with an adverse determination constitutes an appeal of that adverse determination.
    Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 4, eff. April 1, 2007.

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    Structure Texas Statutes

    Texas Statutes

    Insurance Code

    Title 14 - Utilization Review and Independent Review

    Chapter 4201 - Utilization Review Agents

    Subchapter H. Appeal of Adverse Determination

    Section 4201.351. Complaint as Appeal

    Section 4201.352. Written Description of Appeal Procedures

    Section 4201.353. Appeal Procedures Must Be Reasonable

    Section 4201.354. Persons or Entities Who May Appeal

    Section 4201.355. Acknowledgment of Appeal

    Section 4201.356. Decision by Physician Required; Specialty Review

    Section 4201.357. Expedited Appeal for Denial of Emergency Care, Continued Hospitalization, Prescription Drugs or Intravenous Infusions

    Section 4201.358. Response Letter to Interested Persons

    Section 4201.359. Notice of Appeal

    Section 4201.360. Immediate Appeal to Independent Review Organization in Life-Threatening Circumstances

    Section 4201.3601. Immediate Appeal to Independent Review Organization for Denial of Prescription Drugs or Intravenous Infusions

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