TDI Releases Report on Balance Billing Dispute Changes


7/29 TDI Releases Preliminary Report on Balance Billing Dispute Changes 

The Texas Department of Insurance has released a preliminary report on the effects of recent balance billing dispute resolution procedures passed during the 86th Session in Senate Bill 1264. In the report, TDI examined 9,000 requests over the first six months of SB 1264 implementation.

Early findings from the report include:

  • TDI has received 19 consumer complaints about balance billing, down from 546 for the same period in 2019
  • Provider complaints have decreased more than 70% this year, possibly related to new processes for providers seeking to resolve billing disputes
  • More requests are being received for emergency services than in the previous system, though the elective surgery ban may be a factor
  • Final agreed payments under informal settlements look to be similar to those decided by arbitrators
  • TDI has received far fewer requests for mediation than arbitration
  • 38% of provider arbitration requests were for combined claims of less than $5,000

For more information, please see the preliminary report here.