The purpose of this webpage is to inform you of your right to appeal an adverse determination or complaint decision made by your HMO. The information contained on this webpage explains the processes for filing appeals as it relates to the appeal type. Should you choose to file a complaint or appeal, you should be aware that all HMOs are required to maintain a complaint and appeal system. HMOs are prohibited from engaging in retaliatory action against you or anyone authorized to act on your behalf as described in Texas Insurance Code §843.281.
- What are my appeal rights if I am balance billed?
- What are my utilization review appeal rights?
- What are my complaint appeal rights?