Texas Statutes
Chapter 1301 - Preferred Provider Benefit Plans
Subchapter C. Prompt Payment of Claims

Section 1301.101. Definition - Sec. 1301.101. DEFINITION. In this subchapter, "clean claim" means a...

Section 1301.102. Submission of Claim - Sec. 1301.102. SUBMISSION OF CLAIM. (a) A physician or health...

Section 1301.1021. Receipt of Claim - Sec. 1301.1021. RECEIPT OF CLAIM. (a) If a claim for...

Section 1301.103. Deadline for Action on Clean Claims - Sec. 1301.103. DEADLINE FOR ACTION ON CLEAN CLAIMS. Except as...

Section 1301.104. Deadline for Action on Pharmacy Claims; Payment - Sec. 1301.104. DEADLINE FOR ACTION ON PHARMACY CLAIMS; PAYMENT. (a)...

Section 1301.105. Audited Claims - Sec. 1301.105. AUDITED CLAIMS. (a) Except as provided by Section...

Section 1301.1051. Completion of Audit - Sec. 1301.1051. COMPLETION OF AUDIT. The insurer must complete an...

Section 1301.1052. Preferred Provider Appeal After Audit - Sec. 1301.1052. PREFERRED PROVIDER APPEAL AFTER AUDIT. If a preferred...

Section 1301.1053. Deadlines Not Extended - Sec. 1301.1053. DEADLINES NOT EXTENDED. The investigation and determination of...

Section 1301.1054. Requests for Additional Information - Sec. 1301.1054. REQUESTS FOR ADDITIONAL INFORMATION. (a) If an insurer...

Section 1301.106. Claims Processing Procedures and Claims Payment Processes - Sec. 1301.106. CLAIMS PROCESSING PROCEDURES AND CLAIMS PAYMENT PROCESSES. (a)...

Section 1301.107. Contractual Waiver and Other Actions Prohibited - Sec. 1301.107. CONTRACTUAL WAIVER AND OTHER ACTIONS PROHIBITED. Except as...

Section 1301.108. Attorney's Fees - Sec. 1301.108. ATTORNEY'S FEES. A preferred provider may recover reasonable...

Section 1301.109. Applicability to Entities Contracting With Insurer - Sec. 1301.109. APPLICABILITY TO ENTITIES CONTRACTING WITH INSURER. This subchapter...