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Emergency Services Billing Rates - NPIs
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.
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Emergency Services Billing Rates - Contact List
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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.
Emergency Services Billing Rates - Code Rates
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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.
Emergency Services Billing Rates - ZIPs
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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.
Complaint indexes and policy counts for insurance companies
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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.
Independent dispute resolution summary data
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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.
Insurance agencies and businesses approved to manage insurance-related products
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The Texas Department of Insurance (TDI) is responsible for licensing, registering, certifying, and regulating agencies and businesses that want to sell insurance or adjust property and casualty claims in Texas. This data set includes a row for each license held by an agency or business. An agency or business with more than one license will be listed in multiple rows. To view a list of people licensed by TDI, go to the Insurance agent and adjusters data set. To learn more about the type of licenses in this data set, go to TDI’s agent and adjuster licensing webpage. For detailed search results on individual agencies, agents, and adjusters please click here: Detailed reports.
Insurance agents, adjusters, and people approved to manage insurance-related products or claims
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The Texas Department of Insurance (TDI) is responsible for licensing, registering, certifying, and regulating people who sell insurance or adjust property and casualty claims in Texas. This data set includes a row for each license held by a person. A person with more than one license will be listed in multiple rows. To view the list of agencies and business licensed by TDI, go to the Insurance agencies data set. To learn more about the type of licenses in this data set, go to TDI’s agent and adjuster licensing webpage. For detailed search results on individual agencies, agents, and adjusters please click here: Detailed reports.
Professional Medical Billing Services (SV1) Detail Information
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The Texas Department of Insurance, Division of Workers' Compensation (DWC) maintains a database of professional medical billing services (SV1). It contains charges, payments, and treatments billed on a CMS-1500 form by doctors and other health care professionals who treat injured employees, including ambulatory surgical centers, with dates of service for the last five years. For datasets going back to 2010, see professional medical billing services (SV1) detail information – historical. The detail contains information to identify insurance carriers, injured employees, employers, place of service, and diagnostic information. The bill details are individual line items that are grouped in the header section of a single bill. The bill selection date and bill ID must be used to group individual line items into a single bill. Find more information in our professional medical billing services (SV1) detail data dictionary. See professional medical billing services (SV1) header information for the corresponding header records related to this dataset. Go to our page on DWC medical state reporting public use data file (PUDF) to learn more about using this information.
Professional Medical Billing Services (SV1) Header Information
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The Texas Department of Insurance, Division of Workers' Compensation (DWC) maintains a database of professional medical billing services (SV1). It contains charges, payments, and treatments billed on a CMS-1500 form by doctors and other health care professionals who treat injured employees, including ambulatory surgical centers, with dates of service for the last five years. For datasets going back to 2010, see professional medical billing services (SV1) header information – historical. The header identifies insurance carriers, injured employees, employers, place of service, and diagnostic information. The bill header information groups individual line items reported in the detail section. The bill selection date and bill ID must be used to group individual line items into a single bill. Find more information in our professional medical billing services (SV1) header data dictionary. See professional medical billing services (SV1) detail information for the corresponding detail records related to this dataset. Go to our page on DWC medical state reporting public use data file (PUDF) to learn more about using this information.
Workers' compensation insurance coverage subscriber information
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The Texas Department of Insurance, Division of Workers’ Compensation (DWC) publishes a quarterly report of employers with active Texas workers’ compensation insurance coverage. Employers with coverage are called “subscribers.” Texas does not require most private employers to have workers' compensation insurance coverage. Insurance carriers report coverage data to DWC using the International Association of Industrial Accident Boards and Commissions’ (IAIABC) IAIABC Proof of Coverage (POC) Release 2.1 electronic data interchange (EDI) standard. The National Council on Workers’ Compensation Insurance (NCCI) collects the POC data for DWC. POC filings are the source of this data set. Visit the DWC Employer Coverage Page for more information.