Sec. 1301.1021. RECEIPT OF CLAIM. (a) If a claim for medical care or health care services provided to a patient is mailed, the claim is presumed to have been received by the insurer on the fifth day after the date the claim is mailed or, if the claim is mailed using overnight service or return receipt requested, on the date the delivery receipt is signed.
(b) If the claim is submitted electronically, the claim is presumed to have been received on the date of the electronic verification of receipt by the insurer or the insurer's clearinghouse. If the insurer or the insurer's clearinghouse does not provide a confirmation within 24 hours of submission by the physician or health care provider, the physician's or provider's clearinghouse shall provide the confirmation. The physician's or provider's clearinghouse must be able to verify that the filing contained the correct payor identification of the entity to receive the filing.
(c) If the claim is faxed, the claim is presumed to have been received on the date of the transmission acknowledgment.
(d) If the claim is hand delivered, the claim is presumed to have been received on the date the delivery receipt is signed.
Amended by:
Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.037(a), eff. September 1, 2005.
Section: Previous 1301.065 1301.066 1301.067 1301.068 1301.069 1301.101 1301.102 1301.1021 1301.103 1301.104 1301.105 1301.1051 1301.1052 1301.1053 1301.1054 NextLast modified: September 28, 2016