§ 843.336 Definition
§ 843.337 Time for Submission of Claim; Duplicate Claims; Acknowledgment of Receipt of Claim
§ 843.338 Deadline for Action On Clean Claims
§ 843.3385 Additional Information
§ 843.339 Deadline for Action On Prescription Claims; Payment
§ 843.340 Audited Claims
§ 843.3405 Investigation and Determination of Payment
§ 843.341 Claims Processing Procedures
§ 843.342 Violation of Certain Claims Payment Provisions; Penalties
§ 843.343 Attorney’s Fees
§ 843.344 Applicability of Subchapter to Entities Contracting With Health Maintenance Organization
§ 843.345 Exception
§ 843.346 Payment of Claims
§ 843.347 Verification
§ 843.348 Preauthorization of Health Care Services
§ 843.3481 Posting of Preauthorization Requirements
§ 843.3482 Changes to Preauthorization Requirements
§ 843.3483 Remedy for Noncompliance
§ 843.349 Coordination of Payment
§ 843.350 Overpayment
§ 843.351 Services Provided by Certain Physicians and Providers
§ 843.352 Conflict With Other Law
§ 843.353 Waiver Prohibited
§ 843.354 Legislative Declaration

Terms Used In Texas Insurance Code Chapter 843 > Subchapter J - Payment of Claims to Physicians and Providers

  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
  • Contract: A legal written agreement that becomes binding when signed.
  • Donor: The person who makes a gift.
  • Electronic funds transfer: The transfer of money between accounts by consumer electronic systems-such as automated teller machines (ATMs) and electronic payment of bills-rather than by check or cash. (Wire transfers, checks, drafts, and paper instruments do not fall into this category.) Source: OCC
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Fee simple: Absolute title to property with no limitations or restrictions regarding the person who may inherit it.
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • in writing: includes any representation of words, letters, or figures, whether by writing, printing, or other means. See Texas Government Code 312.011
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
  • Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Person: includes corporation, organization, government or governmental subdivision or agency, business trust, estate, trust, partnership, association, and any other legal entity. See Texas Government Code 311.005
  • Property: means real and personal property. See Texas Government Code 311.005
  • Rule: includes regulation. See Texas Government Code 311.005
  • Signed: includes any symbol executed or adopted by a person with present intention to authenticate a writing. See Texas Government Code 311.005
  • Temporary restraining order: Prohibits a person from an action that is likely to cause irreparable harm. This differs from an injunction in that it may be granted immediately, without notice to the opposing party, and without a hearing. It is intended to last only until a hearing can be held.
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • United States: includes a department, bureau, or other agency of the United States of America. See Texas Government Code 311.005
  • Week: means seven consecutive days. See Texas Government Code 311.005
  • Written: includes any representation of words, letters, symbols, or figures. See Texas Government Code 311.005
  • Year: means 12 consecutive months. See Texas Government Code 311.005