28 Tex. Admin. Code § 21.3804 - Requests for Eligibility Statements
(a) A
participating provider may, prior to providing services to an enrollee, request
an eligibility statement using a method designated by the health benefit plan
issuer.
(b) A request under
subsection (a) of this section must include:
(1) the enrollee's full name;
(2) the enrollee's relationship to the
primary enrollee; and
(3) the
enrollee's birth date.
(c) If the participating provider is seeking
information concerning the enrollee's benefits under §
21.3805(c)(2)(B)
of this subchapter (relating to Requirement to Provide Eligibility Statements),
the request must also include a description of the specific type or category of
service.
Notes
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