Stay connected!Use the Independent Dispute Resolution portal to submit mediation and arbitration requests and check on claims.
Texas and federal laws protect Texas consumers from surprise bills.
- Federal law bans balance bills for air ambulance services received on or after January 1, 2022.
- State law bans balance bills for these types of care:
- Emergency care received on or after January 1, 2020.
- Care received on or after January 1, 2020 at in-network facilities when the patient didn’t have a choice of doctors.
- Emergency ground ambulance services received on or after January 1, 2024.
State law provides payment standards and authorizes arbitration (for doctors) and mediation (for facilities) to resolve payment disputes in those cases.
The law carves out a narrow exception when a consumer chooses an out-of-network doctor or provider at an in-network facility.
Learn more in the Balance billing waiver section below.
How can you tell if a plan is regulated by TDI?
- The patient’s insurance card will have TDI or DOI on it. See examples
- The patient is insured through:
- Employees Retirement System of Texas (ERS): HealthSelect and other ERS plans
- Teacher Retirement System of Texas (TRS): TRS ActiveCare and TRS-Care Standard for non-Medicare retirees
- Texas Farm Bureau or an employer plan that has opted into the Texas balance billing laws. The patient's insurance card might have TXI on it.
Federal law
The federal No Surprises Act protects Texas consumers from surprise bills for:
- Air ambulance services.
- Emergency care.
- Care provided at in-network facilities when the patient didn’t have a choice of doctors.
To learn more about federal laws and rules, see the Centers for Medicare & Medicaid Services’ webpages: Overview of rules & fact sheets and Provider requirements and resources.
Resources and webinars
- Centers for Medicare & Medicaid Services’ Provider requirements and resources
- FAQ: What doctors should know about the Texas balance billing law
- Texas mediation and arbitration rules (PDF)
- List of TDI certified mediators and arbitrators
- Recorded webinar: Benchmarking database for providers
- Recorded webinar: Mediation / arbitration portal demo for providers | PowerPoint slides