28 Tex. Admin. Code § 10.120 - Complaint System Required
(a) Each network must
implement and maintain a complaint system compliant with Insurance Code Chapter
1305, Subchapter I, concerning Complaint Resolution, and this subchapter that
provides reasonable procedures for resolving an oral or written
complaint.
(b) For purposes of this
subchapter, a complaint relating to a fee dispute is a complaint from a
provider regarding failure to pay a claim in accordance with the contract
between the network and provider.
Notes
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