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Texas Department of Insurance
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How to get help with a surprise medical bill

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Did you get a bill from a doctor, hospital, or other health care provider you weren’t expecting? Getting a surprise bill like this is called “balance billing.” Here’s what to do.

1. Call your health plan.

Ask why you got the bill and if it’s correct. If it was an emergency, ask your health plan if they processed your claim as an emergency. Some types of insurance, including HMOs and EPOs, must protect you from higher out-of-network bills in emergencies. Texas law includes additional protections for people with state-regulated coverage in cases where they had no meaningful choice of providers.

2. Find out if we can help with mediation.

If the bill is for care delivered before January 1, 2020, it may be eligible for mediation. To see if your bill qualifies for mediation, answer a few easy questions.

3. Call us for help.

If you have a question or don’t think your claim was handled the right way, call us at 800-252-3439.

Question? Call us at 800-252-3439.

Last updated: 5/20/2021