1. (a) In contracts with preferred providers, or in the physician or provider manual or other document that sets forth the procedure for filing claims, or by any other method mutually agreed upon by the contracting parties, an HMO or preferred provider carrier must disclose to its preferred providers:

   1. (1) the address, including a physical address, where claims are to be sent for processing;
   2. (2) the telephone number at which preferred providers' questions and concerns regarding claims may be directed;
   3. (3) any entity along with its address, including physical address and telephone number, to which the HMO or preferred provider carrier has delegated claim payment functions, if applicable;
   4. (4) the mailing address and physical address and telephone number of any separate claims processing centers for specific types of services, if applicable.
2. (b) An HMO or preferred provider carrier shall provide no less than 60 calendar days prior written notice of any changes of address for submission of claims, and of any changes of delegation of claims payment functions, to all affected preferred providers with whom the HMO or preferred provider carrier has contracts.

Source Note:The provisions of this §21.2811 adopted to be effective May 23, 2000, 25 TexReg 4543; amended to be effective October 2, 2001, 26 TexReg 7542; amended to be effective October 5, 2003, 28 TexReg 8647.