Insurance Code § 4201.004

Sec. 4201.004. TELEPHONE ACCESS. (a) A utilization review agent shall: (1) have appropriate personnel reasonably available, by toll-free telephone at least 40 hours per week during normal business hours in this state, to discuss patients' care and allow response to telephone review requests; (2) have a telephone system capable, during hours other than normal business hours, of accepting or recording incoming telephone calls or of providing instructions to a caller; and (3) respond to a call made during hours other than normal business hours not later than the second working day after the later of: (A) the date the call was received; or (B) the date the details necessary to respond have been received from the caller. (b) A utilization review agent must provide to the commissioner a written description of the procedures to be used when responding with respect to poststabilization care subsequent to emergency treatment as requested by a treating physician or other health care provider. Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 4, eff. April 1, 2007. SUBCHAPTER B. APPLICABILITY OF CHAPTER