Dispute Claim Form For Billing Insurance Carriers In Bexar
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If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.
We protect your documents and personal data by following strict security and privacy standards.
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FAQ
If You Have a Complaint File a complaint with the Health Facility Compliance Unit at the Texas Health and Human Services Commission (HHSC). This is the agency ensuring that hospitals and health facilities are providing safe, responsible care. HHSC will also investigate claims of improper hospital billing.
The Texas Department of Insurance can help you with insurance problems, complaints, and questions. File a complaint using its online Insurance Complaint Process. Call (800) 252-3439 if you have questions or need help filing a complaint with them.
Texas has a "timely billing" law. It requires health care service providers to bill a patient no later than the first day of the 11th month after services were provided. If the bill is not sent within the timeframe in the law, the health care service provider cannot try to collect payment for certain charges.
If you want to file a complaint so TDI can look into your issue, this is how it works: Call our Help Line at 800-252-3439 to talk about your issue. We'll ask if you've talked to your company, agent, or adjuster. Sometimes a conversation can clear up an error or misunderstanding.
Follow Up in Writing: Send a written dispute letter to the hospital, clearly stating the issue and including supporting documentation like bills, insurance statements, or receipts. If the charges were not properly processed by your insurance, contact your insurance company to resolve discrepancies.
Submit your complaint electronically via the Online Complaint Form, or print a PDF version COMPLAINT FORM (SPANISH COMPLAINT FORM ) and mail it in, or call the Complaint Hotline 1-800-201-9353 and follow the automated prompts to request a complaint form.
Important information may include: The name of the business or individual you're filing a complaint against; The business/individual's full address, including zip code; A detailed description of your complaint; Transaction dates and amounts; Contract information; Payment information;
