Texas Insurance Code 4201.358 – Response Letter to Interested Persons
Current as of: 2024 | Check for updates
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Terms Used In Texas Insurance Code 4201.358
- 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.
- 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
The procedures for appealing an adverse determination must provide that, after the utilization review agent has sought review of the appeal, the agent shall issue a response letter explaining the resolution of the appeal to:
(1) the patient or a person acting on the patient’s behalf; and
(2) the patient’s physician or other health care provider.