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TITLE 28 - INSURANCE
PART 1 - TEXAS DEPARTMENT OF INSURANCE
CHAPTER 12 - INDEPENDENT REVIEW ORGANIZATIONS
SUBCHAPTER E - FEES AND PAYMENT
SECTION/RULE §12.404 - Payment of Fees
Chapter Review Date 05/06/2022

(a) IROs must bill utilization review agents or payors, as appropriate, directly for fees for independent review.(b) IROs may also bill utilization review agents or payors, as appropriate, for copy expenses related to reviews as set out in §12.205 of this chapter.(c) Utilization review agents or payors, as appropriate, must pay IROs directly within 15 days of receipt of invoice. For workers' compensation network and nonnetwork disputes, the IRO fees must be paid under §133.308 of this title.(d) Utilization review agents may recover from the payors the costs associated with the independent review.

Source Note: The provisions of this §12.404 adopted to be effective November 26, 1997, 22 TexReg 11363; amended to be effective December 26, 2010, 35 TexReg 11281; amended to be effective July 7, 2015, 40 TexReg 2538.

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