§ 1305.351 Utilization Review in Network
§ 1305.353 Notice of Certain Utilization Review Determinations; Preauthorization Requirements
§ 1305.354 Reconsideration of Adverse Determination
§ 1305.355 Independent Review of Adverse Determination
§ 1305.356 Contested Case Hearing On and Judicial Review of Independent Review
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Terms Used In Texas Insurance Code Chapter 1305 > Subchapter H - Utilization Review

  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • in writing: includes any representation of words, letters, or figures, whether by writing, printing, or other means. See Texas Government Code 312.011
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • Person: includes corporation, organization, government or governmental subdivision or agency, business trust, estate, trust, partnership, association, and any other legal entity. See Texas Government Code 311.005
  • Population: means the population shown by the most recent federal decennial census. See Texas Government Code 311.005
  • Rule: includes regulation. See Texas Government Code 311.005
  • Written: includes any representation of words, letters, symbols, or figures. See Texas Government Code 311.005