Texas Insurance Code 4202.012 – Referral
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Terms Used In Texas Insurance Code 4202.012
- Rule: includes regulation. See Texas Government Code 311.005
The commissioner by rule shall require referral by random assignment of adverse determinations under Subchapter I, Chapter 4201, to independent review organizations. On referral of a determination, the commissioner shall notify:
(1) the utilization review agent;
(2) the payor;
(3) the independent review organization;
(4) the patient, as defined by Section 4201.002, or the patient’s representative; and
(5) the provider of record as defined by Section 4201.002.