Texas § 843.253 COMPLAINT INVESTIGATION AND RESOLUTION.

Texas Statutes

§ 843.253 — COMPLAINT INVESTIGATION AND RESOLUTION.

Texas § 843.253

Code INInsurance Code

This text of Texas § 843.253 (COMPLAINT INVESTIGATION AND RESOLUTION.) is published on Counsel Stack Legal Research, covering Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Tex. Insurance Code Code Ann. § 843.253 (2026).

Text

Sec. 843.253. COMPLAINT INVESTIGATION AND RESOLUTION.

(a)A health maintenance organization shall investigate each complaint received in accordance with the health maintenance organization's policies and in compliance with this chapter.

(b)After a health maintenance organization has investigated a complaint, the health maintenance organization shall issue a response letter to the complainant within the time prescribed by Section 843.252 (c) that:

(1)explains the health maintenance organization's resolution of the complaint;

(2)states the specific medical and contractual reasons for the resolution;

(3)states the specialization of any physician or other provider consulted; and

(4)contains a complete description of the process for appeal, including the deadlines for the appeals process a

Free access — add to your briefcase to read the full text and ask questions with AI

Sec. 843.253. COMPLAINT INVESTIGATION AND RESOLUTION. (a) A health maintenance organization shall investigate each complaint received in accordance with the health maintenance organization's policies and in compliance with this chapter.
(b) After a health maintenance organization has investigated a complaint, the health maintenance organization shall issue a response letter to the complainant within the time prescribed by Section 843.252 (c) that:
(1) explains the health maintenance organization's resolution of the complaint;
(2) states the specific medical and contractual reasons for the resolution;
(3) states the specialization of any physician or other provider consulted; and
(4) contains a complete description of the process for appeal, including the deadlines for the appeals process and the deadlines for the final decision on the appeal.