If you are a consumer, please see our consumer section for help. If you are looking for a provider in your health plan network, call your insurance company or HMO.
Physicians and health providers
Information about how to file a complaint, credentialing for fully insured health plans, and prompt payment of claims.
Health Providers
Provider resources
Complaints
- Guidelines for filing complaints from providers about health claim payments
- Tips to help providers avoid claim filing errors
Credentialing
Prompt Pay
- Prompt pay and fraud
- Claims data reporting
- Tips for accurate reporting (PDF)
- Prompt pay guidelines
- FAQs
Professional Liability
Mediation and arbitration
- Balance billing: independent dispute resolution
- FAQ about the mediation and arbitration process
- List of TDI mediators and arbitrators
Resources
- Medicare Advantage tips
- Pharmacists resource page
- Consumer health publications
- HMO-MCQA forms
- Managed Care Payor Resource Page
- Rules
Prior Authorization
Workers' Compensation
Questions? Call us at 800-252-3439.
Last updated:
12/1/2022