Texas Prompt Pay Law

This regulation is directly from the Texas State Department of Insurance
and is specific for manage care/indemnity plans
　

If utilized properly, you will ensure your collections without having to beg and plead

from the desk of:

Mark Studin DC, FASBE(C), DAAPM, DAAMLP

The carriers have 30 days to pay an electronic claim and 45 days to pay a paper claim. Anything beyond that will result in a default of the payment of your claim and mandate the carriers are liable for the contracted rate owed plus the lesser of 50% of the difference billed charges and the contracted rate or $100,000; 100% of the difference or $200,000 between 46-91 days; and for claims paid thereafter 91 days, an additional penalty of 18% interest annually. 

Language for your complaint:

Dear Claims Examiner:

The services rendered were billed within the Texas Insurance guidelines. It has now been beyond 45 working days allowed by Texas Insurance Law, § 3.70-3C.3A (2003)

Since you have violated this regulation we can submit this entire claim for summary judgment or arbitration through our legal counsel.

　We would like to resolve this issue without using legal counsel. If we do go to court, It will cost you both the amount of the claim and attorney fees with 18% interest and significant penalties annually as mandated by regulation Section § 3.70-3C.3A (2003)

　We request payment within 3 weeks of the date of this letter for the resubmitted bill(s) as prescribed by law. By doing so we will waive the interest due us as described in the regulations previously cited. If we do not receive payment, we will be forced to litigate this matter and also file a complaint with the Texas Department of Insurance.

512-463-6169

http://www.tdi.state.tx.us/