Code: 

Insurance Code

Title: 

Title 14. Utilization Review and Independent Review

Section: 

4202.012

Name: 

Referral

Eff. Date: 

September 1, 2013
§4202.012
Referral

The commissioner by rule shall require referral by random assignment of adverse determinations under Subchapter I, Chapter 4201, to independent review organizations. On referral of a determination, the commissioner shall notify:

(1) the utilization review agent;

(2) the payor;

(3) the independent review organization;

(4) the patient, as defined by Section 4201.002, or the patient’s representative; and

(5) the provider of record as defined by Section 4201.002.

Added by Acts 2013, 83rd Leg., ch. 1024 (H.B. 2645), § 5, eff. Sept. 1, 2013.