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Texas Statutes (Last Updated: January 4, 2014) |
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INSURANCE CODE |
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Title 14. UTILIZATION REVIEW AND INDEPENDENT REVIEW |
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Chapter 4202. INDEPENDENT REVIEW ORGANIZATIONS |
Sec. 4202.003. REQUIREMENTS REGARDING TIMELINESS OF DETERMINATION
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The standards adopted under Section 4202.002 must require each independent review organization to make the organization's determination:
(1) for a life-threatening condition as defined by Section 4201.002, not later than the earlier of:
(A) the fifth day after the date the organization receives the information necessary to make the determination; or
(B) the eighth day after the date the organization receives the request that the determination be made; and
(2) for a condition other than a life-threatening condition, not later than the earlier of:
(A) the 15th day after the date the organization receives the information necessary to make the determination; or
(B) the 20th day after the date the organization receives the request that the determination be made.