| (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 |
