Texas § 843.341 CLAIMS PROCESSING PROCEDURES.

Texas Statutes

§ 843.341 — CLAIMS PROCESSING PROCEDURES.

Texas § 843.341

Code INInsurance Code

This text of Texas § 843.341 (CLAIMS PROCESSING PROCEDURES.) 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. § 843.341 (2026).

Text

Sec. 843.341. CLAIMS PROCESSING PROCEDURES.

(a)A health maintenance organization shall provide a participating physician or provider with copies of all applicable utilization review policies and claim processing policies or procedures.

(b)A health maintenance organization's claims payment processes shall:

(1)use nationally recognized, generally accepted Current Procedural Terminology codes, notes, and guidelines, including all relevant modifiers; and

(2)be consistent with nationally recognized, generally accepted bundling edits and logic.

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Sec. 843.341. CLAIMS PROCESSING PROCEDURES. (a) A health maintenance organization shall provide a participating physician or provider with copies of all applicable utilization review policies and claim processing policies or procedures.
(b) A health maintenance organization's claims payment processes shall:
(1) use nationally recognized, generally accepted Current Procedural Terminology codes, notes, and guidelines, including all relevant modifiers; and
(2) be consistent with nationally recognized, generally accepted bundling edits and logic.