28 Tex. Admin. Code § 42.309 - Payment for the Review
(a) The board shall set
reasonable fees for reviewing fee and utilization disputes. The board may
adjust these fees periodically, as necessary.
(b) The review fee shall be paid by check or
money order, payable to Industrial Accident Board.
(c) The carrier, whether requester or
respondent, shall be responsible to pay for the review, unless the board has
found that the provider has overutilized the board's review system.
(d) A provider shall be found to have
overutilized the board's review system after three separate disputes involving
the provider have been presented to the board for review, and have been
resolved by the board against the provider within a 12-month period. The board
will notify a provider when such finding is made, and shall maintain a record
of such findings. In all subsequent reviews of that provider's bills, the
provider, whether requester or respondent, shall be responsible to pay for the
review.
Notes
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