TX · State profile
Medical bill appeals in Texas.
How state appeal law and surprise-billing rules apply in Texas, and the errors we look for.
Appeal law
Texas SB 1264 (2020) created one of the strongest state-level surprise billing protections in the country, with binding arbitration handling provider-insurer disputes outside the patient's exposure. For ERISA self-funded plans, federal NSA applies instead.
Surprise billing
On a Texas case we file under SB 1264 if the plan is state-regulated, and under the federal NSA if it's a self-funded ERISA plan. Knowing which is which is the first step of the audit.
Top insurers you can appeal to in TX
- 01Blue Cross Blue Shield TX
- 02UnitedHealthcare
- 03Aetna
- 04Cigna
- 05Humana
Top error types in TX
- Out-of-network ER physician at in-network ER (most common)
- Inflated ambulance charges (ground ambulance is NOT covered by NSA)
- Duplicate facility fees on emergency department visits
Got a Texas bill?
We file under both federal and TX-specific appeal procedures, whichever gives your case the strongest position. The audit is free.
Try the auditOther states: California · Florida