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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 19LICENSING AND REGULATION OF INSURANCE PROFESSIONALS
SUBCHAPTER RUTILIZATION REVIEWS FOR HEALTH CARE PROVIDED UNDER A HEALTH BENEFIT PLAN OR HEALTH INSURANCE POLICY
DIVISION 1UTILIZATION REVIEWS
RULE §19.1712URA's Telephone Access

(a) Except as otherwise provided by the Insurance Code, a URA must have appropriate personnel reasonably available by toll-free telephone at least 40 hours per week during normal business hours in both Central Time and Mountain Time, to discuss enrollees' care and to respond to telephone review requests.

(b) This section does not apply to an HMO or preferred provider benefit plan that is subject to §19.1718 of this title (relating to Preauthorization for Health Maintenance Organizations and Preferred Provider Benefit Plans) or §19.1719 of this title (relating to Verification for Health Maintenance Organizations and Preferred Provider Benefit Plans).


Source Note: The provisions of this §19.1712 adopted to be effective February 20, 2013, 38 TexReg 892

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