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Tex. Ins. Code § 843.323

CONTRACT PROVISIONS PROHIBITING REJECTION OF BATCHED CLAIMS

Known as the Texas Health Maintenance Organization Act

The act spans §§ 843–843 (146 sections).

Added by Acts 2005, 79th Leg., Ch. 668 (S.B. 50), Sec. 1, eff

(a) If requested by a participating physician or provider, a health maintenance organization shall include a provision in the physician's or provider's contract providing that the health maintenance organization or the health maintenance organization's clearinghouse may not refuse to process or pay an electronically submitted clean claim, as defined by Subchapter J, because the claim is submitted together with or in a batch submission with a claim that is not a clean claim.

(b) In accordance with Chapters 82 and 84, the commissioner may issue a cease and desist order against or impose sanctions on a health maintenance organization that violates this section or a contract provision adopted under this section.

Official source: Texas Constitution and Statutes. Reproduced from public-domain Texas statutes; confirm against the official source for the current text. Not legal advice.