The Texas Department of Insurance (TDI) collects and reports information about billing rates for emergency service providers by procedure code as set by the political subdivisions. The procedure codes include Healthcare Common Procedure Coding System (HCPCS) Codes and any other codes reported by the political subdivisions. This dataset lists the codes and the rates for residents of that political subdivision and for non-residents if that rate differs. There is a row for each procedure code and the rates set by a political subdivision. Political subdivisions with more than one code with a rate set will be listed in multiple rows. The data includes the year and quarter the information applies to as well as the date the political subdivision submitted their report.

The Texas Legislature amended Texas Insurance Code Chapter 38 via Senate Bill 2476 during the 88th session to add reporting “relating to consumer protections against certain medical and health care billing by emergency medical services providers. A political subdivision may submit to the department a rate set, controlled, or regulated by the political subdivision for emergency services.”

► For contact information, refer to dataset:  Emergency Services Billing Rates - Contact List.

► For National Provider Identifier Standard (NPI) information reported in each political subdivision, refer to dataset: Emergency Services Billing Rates - NPI.

► For ZIP codes within political subdivisions, refer to dataset:  Emergency Services Billing Rates - ZIPs.

Users are responsible for reviewing and updating data before the submission deadlines. Information entered or found in this dataset is subject to change. Visit TDI’s web site disclaimer for more information.

For more information related to this data, visit TDI’s FAQ page.

► The Texas Department of Insurance (TDI) handles complaints against people and organizations licensed by TDI, such as companies, agents, and adjusters. To learn more, go to the TDI webpage, How to get help with an insurance issue or file a complaint.&nbsp ► This dataset includes a row for each person and organization named in a complaint. This means some complaint numbers are listed multiple times. To view a dataset that lists each complaint number once due to removing the “Complaint filed against” column, use TDI Complaints: One Record / Complaint.

The Texas Department of Insurance (TDI) collects and reports information about billing rates for emergency service providers within political subdivisions as reported by those political subdivisions. The Zone Improvement Plan (ZIP) code is a unique seven-digit identification number for postal delivery in the United States. This dataset relates political subdivisions and ZIP codes they contain by year and quarter. There is a row for each ZIP code within a political subdivision. Subdivisions containing more than one ZIP code or providers operating in more than one subdivision will be listed in multiple rows. The data includes the year and quarter the information applies to as well as the date the political subdivision submitted their report.

The Texas Legislature amended Texas Insurance Code Chapter 38 via Senate Bill 2476 during the 88th session to add reporting “relating to consumer protections against certain medical and health care billing by emergency medical services providers. A political subdivision may submit to the department a rate set, controlled, or regulated by the political subdivision for emergency services.”

► For contact information, refer to dataset:  Emergency Services Billing Rates - Contact List.

► For procedure codes rates, refer to dataset:  Emergency Services Billing Rates - Code Rates.

► For National Provider Identifier Standard (NPI) information reported in each political subdivision, refer to dataset: Emergency Services Billing Rates - NPI.

Users are responsible for reviewing and updating data before the submission deadlines. Information entered or found in this dataset is subject to change. Visit TDI’s web site disclaimer for more information.

For more information related to this data, visit TDI’s FAQ page.

The Texas Department of Insurance (TDI) collects and reports information about billing rates for emergency service providers within political subdivisions as set by those political subdivisions. This dataset includes contact information for the reporting political subdivisions. There is a row for the contact information for each reporter and their political subdivision by year and quarter. The data also includes the date the political subdivision reported it.

The Texas Legislature amended Texas Insurance Code Chapter 38 via Senate Bill 2476 during the 88th session to add reporting “relating to consumer protections against certain medical and health care billing by emergency medical services providers. A political subdivision may submit to the department a rate set, controlled, or regulated by the political subdivision for emergency services.”

► For procedure codes rates, refer to dataset:  Emergency Services Billing Rates - Code Rates.

► For National Provider Identifier Standard (NPI) information reported in each political subdivision, refer to dataset: Emergency Services Billing Rates - NPI.

► For ZIP codes within political subdivisions, refer to dataset:  Emergency Services Billing Rates - ZIPs.

Users are responsible for reviewing and updating data before the submission deadlines. Information entered or found in this dataset is subject to change. Visit TDI’s web site disclaimer for more information.

For more information related to this data, visit TDI’s FAQ page.

The Texas Department of Insurance (TDI) collects and reports information about billing rates for emergency service providers within political subdivisions as reported by those political subdivisions. The National Provider Identifier Standard (NPI) is a unique ten-digit identification number for covered health care providers. This dataset relates emergency service providers by NPI with the political subdivisions where they operate by year and quarter. There is a row for each emergency service provider operating within a political subdivision. Subdivisions with more than one provider operating in them or providers operating in more than one subdivision will be listed in multiple rows. The data includes the year and quarter the information applies to as well as the date the political subdivision submitted their report.

The Texas Legislature amended Texas Insurance Code Chapter 38 via Senate Bill 2476 during the 88th session to add reporting “relating to consumer protections against certain medical and health care billing by emergency medical services providers. A political subdivision may submit to the department a rate set, controlled, or regulated by the political subdivision for emergency services.”

► For contact information, refer to dataset:  Emergency Services Billing Rates - Contact List.

► For procedure codes rates, refer to dataset:  Emergency Services Billing Rates - Code Rates.

► For ZIP codes within political subdivisions, refer to dataset:  Emergency Services Billing Rates - ZIPs.

Users are responsible for reviewing and updating data before the submission deadlines. Information entered or found in this dataset is subject to change. Visit TDI’s web site disclaimer for more information.

For more information related to this data, visit TDI’s FAQ page.

► The Texas Department of Insurance (TDI) handles complaints against people and organizations licensed by TDI, such as companies, agents, and adjusters. To learn more, go to the TDI webpage, How to get help with an insurance issue or file a complaint.&nbsp ► This dataset does not include the person or organization the complaint is filed against. To view the dataset that includes the "Complaint filed against" column, use TDI Complaints: All Data.

This pie chart shows the total number of complaints closed by the Texas Department of Insurance for each insurance company. The category "(Other)" represents licensees, like agents and adjusters and small insurance companies not listed in the chart legend, but included in the dataset.

The Texas Department of Insurance administers Independent Dispute Resolution (IDR), a mediation and arbitration process for certain health care billing disputes between out-of-network providers and health plans. Mediation is used for billing disputes between out-of-network facilities and health plans. Arbitration is used for billing disputes between out-of-network health care providers (not facilities) and health plans. Medical services or supplies received on or after January 1, 2020 may be eligible for IDR. To learn more, go to the TDI webpage, Mediation and arbitration of medical bills.

This dataset includes information related to network adequacy waiver requests filed by major medical health benefit plans. It includes data on physicians, providers, and facilities, other than facility-based physicians and providers. Related datasets are available for major medical (facility-based providers) and vision plans:

• Facility-based Physicians & Providers: Network Adequacy Waiver Request - Facility based Physicians & Providers.This dataset relates to waiver requests for networks used for major medical PPO and EPO plans and includes data on facility-based physicians and providers.

• Vision: Network Adequacy Waiver Request - Vision. This dataset relates to waiver requests for networks used for vision PPO and EPO plans.

Insurers offering health benefits through a preferred or exclusive provider benefit plan (also called PPO and EPO plans) are required to demonstrate that the health insurance network meets Texas network adequacy standards. When a network does not meet these requirements and has a deficiency in a county for a specific physician or provider specialty type, an insurer may apply for a waiver to continue operating within its service area. The commissioner of the Texas Department of Insurance (TDI) may grant the waiver following a public hearing and consideration of relevant testimony and information.

Anyone may attend the public hearing and offer testimony. Learn more about how to submit information related to a waiver request or participate in a hearing here: Network Adequacy Standards Waivers.

The Texas Department of Insurance (TDI) regulates the state’s insurance industry and oversees the administration of the Texas workers’ compensation system. This data set includes counts for confirmed complaints and policies in force by company name and line of coverage. The complaint index is calculated by dividing the company's percentage of complaints for a specific line of insurance by the company's percentage of policies in force for the same line of insurance. The average index is 1.00. A number less than 1 indicates fewer complaints than average. A number greater than 1 indicates more complaints than average. Please visit TDI Complaints: All Data for details about processed complaints.