28 Tex. Admin. Code § 21.5001 - Purpose
The purpose of this subchapter is to:
(1) prescribe the process for requesting,
initiating, and conducting mandatory mediation and mandatory binding
arbitration of claims as authorized in Insurance Code Chapter 1467, concerning
Out-of-Network Claim Dispute Resolution;
(2) facilitate the process for the
investigation and review of a complaint filed with the department that relates
to the settlement of an out-of-network claim under Insurance Code Chapter
1467;
(3) prescribe the contents of
the explanation of benefits as required by Insurance Code §
1271.008, concerning
Balance Billing Prohibition Notice; §1275.003, concerning Balance Billing
Prohibition Notice; §1301.010, concerning Balance Billing Prohibition
Notice; §1551.015, concerning Balance Billing Prohibition Notice;
§1575.009, concerning Balance Billing Prohibition Notice; and
§1579.009, concerning Balance Billing Prohibition Notice; and
(4) facilitate the collection of data as
authorized in Insurance Code §
1467.006, concerning
Benchmarking Database.
Notes
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