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Current as of January 01, 2024 | Updated by Findlaw Staff
(a) An out-of-network provider or a health benefit plan issuer or administrator may request mediation of a settlement of an out-of-network health benefit claim through a portal on the department's Internet website if:
(1) there is an amount billed by the provider and unpaid by the issuer or administrator after copayments, deductibles, and coinsurance for which an enrollee may not be billed; and
(2) the health benefit claim is for:
(A) emergency care;
(B) an out-of-network laboratory service; or
(C) an out-of-network diagnostic imaging service.
(b) If a person requests mediation under this subchapter, the out-of-network provider or the provider's representative, and the health benefit plan issuer or the administrator, as appropriate, shall participate in the mediation.
(c) Repealed by Acts 2019, 86th Leg., ch. 1342 (S.B. 1264), § 3.03(3).
(d) Repealed by Acts 2019, 86th Leg., ch. 1342 (S.B. 1264), § 3.03(3).
Cite this article: FindLaw.com - Texas Insurance Code - INS § 1467.051. Availability of Mandatory Mediation - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-1467-051/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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