Texas Insurance Code 1467.089 – Effect of Decision
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(a) An arbitrator’s decision under Section 1467.088 is binding.
(b) Not later than the 45th day after the date of an arbitrator’s decision under Section 1467.088, a party not satisfied with the decision may file an action to determine the payment due to an out-of-network provider.
Terms Used In Texas Insurance Code 1467.089
- 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.
(c) In an action filed under Subsection (b), the court shall determine whether the arbitrator’s decision is proper based on a substantial evidence standard of review.
(d) Not later than the 30th day after the date of an arbitrator’s decision under Section 1467.088, a health benefit plan issuer or administrator shall pay to an out-of-network provider any additional amount necessary to satisfy the binding award.