OPTUMRX, INC. — health Complaints in Texas
Detailed analysis of 102 health insurance complaints filed against OPTUMRX, INC. by consumers in Texas, based on public NAIC and state DOI data.
Key Statistics
- health Complaints in Texas: 102
- Total health Complaints (All States): 102
- Texas Share: 100.0%
- AI Risk Score: 43/100
Analysis: OPTUMRX, INC. health in Texas
OPTUMRX, INC. has accumulated 102 health insurance complaints from consumers in Texas. Across all states, OPTUMRX, INC. has 102 total health complaints, making Texas responsible for 100.0% of the volume.
The most frequent complaint sub-type is Claim denial with 52 complaints. Other common issues include Delayed payment (18), Den/N-Pymt MD Nec RX | No Jurisdiction (3), Unfair settlement (2).
The most active year was 2026 with 2 complaints filed.
Consumers in Texas who have health disputes with OPTUMRX, INC. can file a complaint with the Texas Department of Insurance.
health Complaint Issues in Texas
| Issue Type | Complaints | % |
|---|---|---|
| Claim denial | 52 | 51.0% |
| Delayed payment | 18 | 17.6% |
| Den/N-Pymt MD Nec RX | No Jurisdiction | 3 | 2.9% |
| Unfair settlement | 2 | 2.0% |
| Other | Contract Language/Legal Issue; Information Furnished; Company Position Upheld | 2 | 2.0% |
| Cust Service Claim Handling | Information Furnished | 2 | 2.0% |
| Den/N-Pymt MD Nec RX | Contract Language/Legal Issue | 2 | 2.0% |
| Coverage dispute | 2 | 2.0% |
| Other | Information Furnished | 2 | 2.0% |
| Den/N-Pymt MD Nec RX | Information Furnished | 2 | 2.0% |
| Not Within TDI Jurisdiction | Contract Language/Legal Issue; Information Furnished | 1 | 1.0% |
| Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken | 1 | 1.0% |
| Unsatisfactory Settle/Offer | Information Furnished | 1 | 1.0% |
| Other | Contract Language/Legal Issue; Company Position Upheld; Information Furnished | 1 | 1.0% |
| Access to Care | No Jurisdiction | 1 | 1.0% |
| Essential Health Benefit | Referred To; No Jurisdiction | 1 | 1.0% |
| Other | Insufficient Information | 1 | 1.0% |
| Continuity of Treatment; Den/N-Pymt MD Nec RX; Notice Requirements | Insufficient Information | 1 | 1.0% |
| Access to Care; Continuity of Treatment; Den/N-Pymt MD Nec RX | Information Furnished; Contract Language/Legal Issue | 1 | 1.0% |
| Other | Information Furnished; Record Only | 1 | 1.0% |
| Material Change To Contract | Information Furnished | 1 | 1.0% |
| Den/N-Pymt MD Nec RX | 1 | 1.0% |
| Unsatisfactory Settle/Offer | Additional Monies Received; Contract Language/Legal Issue | 1 | 1.0% |
| Other | No Jurisdiction | 1 | 1.0% |
| Cust Service Claim Handling; Den/N-Pymt MD Nec RX; Unsatisfactory Settle/Offer | No Jurisdiction | 1 | 1.0% |
Complaints by Year
- 2026: 2 complaints
- 2025: 3 complaints
- 2024: 5 complaints
- 2023: 39 complaints
- 2022: 3 complaints
- 2021: 2 complaints
- 2018: 6 complaints
- 2017: 9 complaints
- 2016: 10 complaints
- 2015: 11 complaints
- 2014: 7 complaints
- 2013: 5 complaints
Recent health Complaints Against OPTUMRX, INC. in Texas
- health Complaint #TX-449326-194d1329 (2026-03-05) — Delayed payment
- health Complaint #TX-444717-42764cb5 (2026-01-14) — Not Within TDI Jurisdiction | Contract Language/Legal Issue; Information Furnished
- health Complaint #TX-440495-7ff2b391 (2025-11-21) — Recoupment Of Claims Payment; Unsatisfactory Settle/Offer | Corrective Action Taken
- health Complaint #TX-440344-1d2faaa0 (2025-11-20) — Unfair settlement
- health Complaint #TX-440228-1d2faaa0 (2025-11-19) — Unfair settlement
- health Complaint #TX-404547-75a6518d (2024-09-20) — Delayed payment
- health Complaint #TX-402371-75a6518d (2024-09-03) — Delayed payment
- health Complaint #TX-396541-dd1eeca4 (2024-06-27) — Delayed payment
- health Complaint #TX-383893-9e819ae1 (2024-01-29) — Unsatisfactory Settle/Offer | Information Furnished
- health Complaint #TX-382320-dd1eeca4 (2024-01-09) — Delayed payment
Frequently Asked Questions
How many health complaints does OPTUMRX, INC. have in Texas?
OPTUMRX, INC. has 102 health insurance complaints on file from consumers in Texas, according to NAIC and state DOI data.
What are the most common health complaint issues with OPTUMRX, INC. in Texas?
The most common issues are: Claim denial (52), Delayed payment (18), Den/N-Pymt MD Nec RX | No Jurisdiction (3), Unfair settlement (2), Other | Contract Language/Legal Issue; Information Furnished; Company Position Upheld (2).
How does OPTUMRX, INC.'s health record in Texas compare to other states?
OPTUMRX, INC. has 102 health complaints in Texas out of 102 total health complaints nationwide. That is 100.0% of their health volume.
Where can I file a health complaint against OPTUMRX, INC. in Texas?
You can file a complaint with the Texas Department of Insurance. The NAIC Consumer Information Source at https://content.naic.org/cis_consumer.htm also accepts complaints.