{"data":{"id":"us-tx/tex.-insurance-code-1301.106","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 1301.106","heading":"CLAIMS PROCESSING PROCEDURES AND CLAIMS PAYMENT PROCESSES.","body":"(a) An insurer shall provide a preferred provider with copies of all applicable utilization review policies and claim processing policies or procedures.\n(b) An insurer's claims payment processes shall:\n(1) use nationally recognized, generally accepted Current Procedural Terminology codes, notes, and guidelines, including all relevant modifiers; and\n(2) be consistent with nationally recognized, generally accepted bundling edits and logic.\nAdded by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.\nAmended by:\nActs 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.037(a), eff. September 1, 2005.","path":["INSURANCE CODE","TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES","SUBTITLE D. PROVIDER PLANS","CHAPTER 1301. PREFERRED PROVIDER BENEFIT PLANS","SUBCHAPTER C. PROMPT PAYMENT OF CLAIMS"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1301.htm#1301.106","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"3b874d097810edd8199737e2ddc45c5b2291353c5cb6a488aaae245e8161cd9e","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-1301.1054","next":"us-tx/tex.-insurance-code-1301.107"},"notice":"GroundRules: Original legal text. Not legal advice."}