State IDR guide
Texas Independent Dispute Resolution Guide
- Responsible agency
- Texas Department of Insurance
- Review date
Texas is a bifurcated state. TDI mediation or arbitration may govern qualifying services under TDI-regulated plans; the remedy depends on provider/facility and service type.
Plan and jurisdiction considerations
Confirm the ID card indicates TDI-regulated coverage, then test provider type, facility, service, and payment facts. Most ERISA self-funded plans use Federal IDR.
Federal fallback
Use Federal IDR for eligible claims not subject to the Texas process.
Timing and fees
Texas requires an informal settlement period after a request and has program-specific filing thresholds, forms, and neutral costs. Verify the current TDI portal instructions for the claim.
Air ambulance considerations
Air ambulance services generally use Federal IDR; ground ambulance rules are different and federal NSA protections generally do not cover ground ambulance.