Recently the Texas Department of Insurance (TDI) contracted with Fair Health to provide healthcare cost metrics to providers in Texas. Through this initiative providers with an authorized TDI registration will be able to obtain access to a suite of benchmark modules and Fair Health Benchmarks through their online platform. This suite of information will assist providers in determining the cost of doing business through multiple pathways:
- Reimbursement of provider charges
- In-network payments
- Out of network payments
- Trends by regional area and CPT codes (based on zip code)
- Medical CPT code allowables by insurance payors
- Fee estimator for services performed
- Medicare GapFill
- Helping providers to determine the best reimbursement model for Medicare and how to determine payments for services which CMS does not identify a value
The goal with this initiative by the Texas Department of Insurance is to help create price transparency between the consumer and the provider as well as advocate for better education on what it costs to provide medical services in the State of Texas. If you are provider in Texas and are interested in receiving these benefits, contact 1-800-578-4677 (TDI) or 1-855-301-3247 (Fair Health).