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Texas Department of Insurance
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Follow-up Q&A: December clean claims reporting webinar

During the December clean claims reporting webinar, we showed you the new features of our Prompt payment of clean claims reports portal. The new features will be available on April 1 for you to report your first quarter 2022 claims data.

Create a test JSON file:

Use this JSON schema, and email it to by February 28, 2022. The mapping Excel sheet identifies your claim data required for the JSON fields.

Answers to some questions we received during the webinar:

What is the correct claim reporting rule?

The speaker cited the claim reporting rule in error. The correct rule is Title 28 of the Texas Administrative Code (TAC) 21.2821.

How do we get the reference sheets you mentioned?

The JSON schema and mapping Excel sheet are both online.

Will there be closed captions available for this meeting?

Yes, the video of the webinar has closed captions, and here is a copy of the transcript.

Should carriers include all claims with the required claim-level data?

Only include clean claims paid late in your claim-level data. The definition of a clean claim is in TAC 21.2803. The requirements related to deficient claims are in TAC 21.2808.

When is the penalty payment due?

  • For clean claims paid late in November and December 2021: Visit our Prompt payment of clean claims page and follow the instructions in the section titled, Prompt pay penalty reporting.” Use HMO/insurer prompt pay penalty reporting form (Form FIN593).
  • For clean claims paid late between January and March 2022: Enter your first quarter 2022 payment information for penalties and interest owed to TDI in the claims portal between April 1 and May 15. You must submit your quarterly claim data through the portal before you can enter your payment information.

Will you open the portal before May to give us more time to enter the new data?

Yes. We will open the portal on April 1 and close it May 16. If you need to use the portal after May 15 or need to correct any data, email us at

What if we report some information and the third-party administrator (TPA) reports more information later?

Carriers must report their claims data to TDI and may delegate the reporting to a Texas-licensed TPA. Carriers and TPAs may share information with each other to ensure the data is reported on time.

Will your notes be available?

No, notes are not available because the webinar is available on our website.

Would it be possible to send a follow up email to all attendees with all questions submitted in today's chat, so we have this documented in writing?

No, we will not email all questions, but the copy of the transcript is available on our website.

Will you add FAQs to the website?

No. The webinar is available on our website.

For more information, contact:

Last updated: 7/6/2022