Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 21 - TRADE PRACTICES
Subchapter T - SUBMISSION OF CLEAN CLAIMS
Section 21.2808 - Effect of Filing Deficient Claim
Universal Citation: 28 TX Admin Code § 21.2808
Current through Reg. 50, No. 13; March 28, 2025
If an MCC determines that a submitted claim is deficient, the MCC must notify the preferred provider submitting the claim that the claim is deficient within 45 calendar days of the MCC's receipt of the nonelectronic claim, or within 30 days of receipt of an electronic claim. If an MCC determines that a claim for a prescription benefit is deficient, the MCC must notify the provider that the claim is deficient within 21 calendar days of the MCC's receipt of the nonelectronic claim, or within 18 days of receipt of an electronic claim.
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