 |
Texas Statutes (Last Updated: January 4, 2014) |
 |
INSURANCE CODE |
|
Title 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES |
|
Subtitle D. PROVIDER PLANS |
|
Chapter 1301. PREFERRED PROVIDER BENEFIT PLANS |
|
Subchapter C-1. OTHER PROVISIONS RELATING TO PAYMENT OF CLAIMS |
Sec. 1301.132. OVERPAYMENT
-
(a) An insurer may recover an overpayment to a physician or health care provider if:
(1) not later than the 180th day after the date the physician or provider receives the payment, the insurer provides written notice of the overpayment to the physician or provider that includes the basis and specific reasons for the request for recovery of funds; and
(2) the physician or provider does not make arrangements for repayment of the requested funds on or before the 45th day after the date the physician or provider receives the notice.
(b) If a physician or health care provider disagrees with a request for recovery of an overpayment, the insurer shall provide the physician or provider with an opportunity to appeal, and the insurer may not attempt to recover the overpayment until all appeal rights are exhausted.