Texas Insurance Code 848.107 – Complaint Systems
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(a) A health care collaborative shall implement and maintain complaint systems that provide reasonable procedures to resolve an oral or written complaint initiated by:
(1) a patient who received health care services provided by a participating physician or health care provider; or
(2) a participating physician or health care provider.
(b) The complaint system for complaints initiated by patients must include a process for the notice and appeal of a complaint.
Terms Used In Texas Insurance Code 848.107
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
- Written: includes any representation of words, letters, symbols, or figures. See Texas Government Code 311.005
(c) A health care collaborative may not take a retaliatory or adverse action against a physician or health care provider who files a complaint with a regulatory authority regarding an action of the health care collaborative.