The Texas Department of Insurance, Division of Workers' Compensation (DWC) maintains a database of institutional medical billing services (SV2). It contains charges, payments, and treatments billed on a CMS-1450 form (UB-92, UB-04) by hospitals and medical facilities that treat injured employees, excluding ambulatory surgical centers, with dates of service for the last five years. For datasets going back to 2010, see institutional medical billing services (SV2) 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 institutional medical billing services (SV2) header data dictionary. See institutional medical billing services (SV2) 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.

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.

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.

This data is from the California Department of Managed Health Care (DMHC). It contains all decisions from Independent Medical Reviews (IMR) administered by the DMHC since January 1, 2001. An IMR is an independent review of a denied, delayed, or modified health care service that the health plan has determined to be not medically necessary, experimental/investigational or non-emergent/urgent. If the IMR is decided in an enrollees favor, the health plan must authorize the service or treatment requested.

This data is from the California Department of Managed Health Care (DMHC). It contains all decisions from Independent Medical Reviews (IMR) administered by the DMHC since January 1, 2001. An IMR is an independent review of a denied, delayed, or modified health care service that the health plan has determined to be not medically necessary, experimental/investigational or non-emergent/urgent. If the IMR is decided in an enrollees favor, the health plan must authorize the service or treatment requested.

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.

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.

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.