Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 12 - INDEPENDENT REVIEW ORGANIZATIONS
Subchapter E - FEES AND PAYMENT
Section 12.404 - Payment of Fees
Universal Citation: 28 TX Admin Code § 12.404
Current through Reg. 50, No. 13; March 28, 2025
(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.
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