Form LHL009 Request for a Review by an Independent Review Organization (Iro) - Texas

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of Form LHL009 for the current year.

Form LHL009 Request for a Review by an Independent Review Organization (Iro) - Texas

What Is Form LHL009?

This is a legal form that was released by the Texas Department of Insurance - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form LHL009?
A: Form LHL009 is a Request for a Review by an Independent Review Organization (IRO) in Texas.

Q: What is an Independent Review Organization (IRO)?
A: An Independent Review Organization (IRO) is an organization that reviews medical decisions to determine if they were appropriate.

Q: Why would someone need to submit Form LHL009?
A: Someone would need to submit Form LHL009 to request a review of a medical decision made by their insurance company.

Q: Who can submit Form LHL009?
A: The person who is affected by the medical decision or their authorized representative can submit Form LHL009.

Q: What information is required on Form LHL009?
A: Form LHL009 requires information such as contact details, insurance information, and details about the medical decision being reviewed.

Q: What happens after Form LHL009 is submitted?
A: After Form LHL009 is submitted, the Independent Review Organization (IRO) will review the medical decision and provide a decision within a certain timeframe.

Q: Is there a fee to submit Form LHL009?
A: No, there is no fee to submit Form LHL009.

Q: Can Form LHL009 be submitted electronically?
A: Yes, Form LHL009 can be submitted electronically if the option is available.

Q: What can someone do if they disagree with the decision made by the Independent Review Organization (IRO)?
A: If someone disagrees with the decision made by the Independent Review Organization (IRO), they may have additional options for appeal, such as filing a complaint with the Texas Department of Insurance.

ADVERTISEMENT

Form Details:

  • Released on December 1, 2017;
  • The latest edition provided by the Texas Department of Insurance;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form LHL009 by clicking the link below or browse more documents and templates provided by the Texas Department of Insurance.

Download Form LHL009 Request for a Review by an Independent Review Organization (Iro) - Texas

4.6 of 5 (7 votes)
  • Form LHL009 Request for a Review by an Independent Review Organization (Iro) - Texas

    1

  • Form LHL009 Request for a Review by an Independent Review Organization (Iro) - Texas, Page 2

    2

  • Form LHL009 Request for a Review by an Independent Review Organization (Iro) - Texas, Page 3

    3

  • Form LHL009 Request for a Review by an Independent Review Organization (Iro) - Texas, Page 4

    4

  • Form LHL009 Request for a Review by an Independent Review Organization (Iro) - Texas, Page 1
  • Form LHL009 Request for a Review by an Independent Review Organization (Iro) - Texas, Page 2
  • Form LHL009 Request for a Review by an Independent Review Organization (Iro) - Texas, Page 3
  • Form LHL009 Request for a Review by an Independent Review Organization (Iro) - Texas, Page 4
Prev 1 2 3 4 Next
ADVERTISEMENT

Related Documents