Medical Billing Services in Texas
EnVisionMD RCM is a medical billing and revenue cycle management (RCM) partner for independent practices and clinics across Texas — from Houston, San Antonio, Dallas and Austin. We handle coding, claim submission, denial management and provider credentialing so your Texas practice gets paid faster and cleaner.
Get a free Texas billing auditAbout medical billing in Texas
Getting paid in Texas means working three lanes at once. On the Medicaid side, coverage runs through Texas Medicaid, delivered through STAR managed-care plans and administered via TMHP — each pathway with its own prior-authorization rules, portals and filing windows. We map every Texas patient to the right lane so claims don’t bounce between fee-for-service and managed care.
On Medicare, Texas Part A and Part B are handled by Novitas Solutions under Jurisdiction H (JH), which also serves several South Central states. The largest commercial payer is Blue Cross and Blue Shield of Texas, alongside national names like Aetna, Cigna and UnitedHealthcare. We submit to all of them every day and track each payer’s edit rules — not a generic “we bill everywhere” line, but the exact requirements that get Texas claims paid without a second pass.
The complete Texas billing & RCM cycle we run
We manage the entire revenue cycle for your Texas practice — every step below, in one connected workflow, mapped to the exact payers you work with.
Patient registration & demographics
Front-desk intake and payer/plan details captured correctly — the step that prevents most later denials.
Eligibility & benefits verification
We verify coverage, copay, deductible and plan in real time so there are no surprises at the visit.
Prior authorization
Prior-auth requests submitted and tracked for every service that needs one, across all payer types.
Charge capture & entry
All billable services captured at the point of care — nothing slips through, no revenue left behind.
Medical coding (CPT / ICD-10 / HCPCS)
CPT, ICD-10 and HCPCS coded accurately with the correct modifiers for each payer.
Claim scrubbing & submission
Every claim scrubbed against payer edits and transmitted electronically through the clearinghouse.
Payment posting (ERA/EOB)
Remittances (ERA/EOB) posted and reconciled so your books always tie out.
Denial management & appeals
Denials investigated, root-caused and appealed on time — we don’t write revenue off.
A/R follow-up
Aging and unpaid claims chased down methodically until each one is resolved.
Patient billing & collections
Patient statements sent clearly, with courteous follow-up on post-insurance balances.
Provider credentialing & enrollment
We maintain CAQH and handle payer/Medicaid enrollment so providers can bill from day one.
Reporting & analytics
Reporting you can act on — clean-claim rate, A/R days and denial trends, reviewed together.
Managed end-to-end by the EnVisionMD RCM billing team.
Texas timely filing limits — quick reference
Typical timely-filing windows for the major Texas payers. These are standard published limits — we track your exact contractual limit for every payer you’re contracted with, because plan-level contracts can differ.
| Payer | Typical timely filing | Notes |
|---|---|---|
| Medicare (Novitas Solutions, Jurisdiction H (JH)) | 365 days | Federal one-year limit from date of service |
| Texas Medicaid | ~90–365 days | Fee-for-service vs. managed-care plan can differ |
| Blue Cross and Blue Shield of Texas | ~90–180 days | Commercial; check group contract |
| Aetna / Cigna / UnitedHealthcare | 90–180 days | Plan-dependent |
Texas rules and payers that affect your cash flow
Prompt-pay law
Texas, like most states, requires insurers to pay clean claims within a set timeframe or owe interest — we file clean, complete claims fast so those rules work in your favor.
Medicaid status
Texas has not adopted ACA Medicaid expansion — so eligibility, self-pay and sliding-scale situations need careful front-end handling, which we build into intake and verification.
Medicare = Novitas Solutions
Texas Part A/B runs through Novitas Solutions (Jurisdiction H (JH)) — we bill and appeal to the correct MAC.
Disputes → state regulator
When a payer dispute can’t be resolved directly it escalates to the Texas Department of Insurance — so we document claims to that standard from the start.
What we bill for Texas practices
CPT is a national code set — but which codes you use most, and how each Texas payer reimburses them, does vary. We build payer-specific rules around your highest-volume services:
Tuned to your specialty mix — a primary-care group in Houston and a behavioral-health practice in San Antonio work from different code and payer rules.
Built for Texas practices
We manage billing and RCM for independent Texas practices as a dedicated extension of your front office — mapped to the exact payers you work with and aligned with the standards Texas providers already follow. We keep credentialing current through CAQH and Texas Medicaid enrollment, and we stay aligned with guidance from the Texas Medical Association and state payer-policy updates.
Serving practices across Texas
EnVisionMD RCM supports independent practices across Texas — from Houston, San Antonio, Dallas and Austin. We bill Texas’s public programs and commercial payers, keep enrollments current with Texas Medicaid, and align documentation to Texas Department of Insurance requirements, Texas Medical Association guidance, and county and state health-department rules.
Texas medical billing questions
Straight answers to the questions Texas practices ask us most.
Get a free Texas billing audit
We’ll review a sample of your Texas claims and show you exactly where revenue is leaking — before you commit to anything.
Request my free auditStatewide Billing Muscle for Texas Providers
Texas is enormous, and so is the administrative load facing a clinic here. EnVisionMD RCM was built to carry it, serving groups in Houston, San Antonio, Dallas, and the capital city of Austin with a full revenue cycle operation that scales alongside a growing practice. In the South Central region, where patient volume can spike fast, keeping claims clean on the first pass is what separates a healthy month from a stressful one.
Novitas Solutions administers Medicare Part B across Jurisdiction JH, and we shape our submissions to satisfy those edits while managing Texas Medicaid and commercial filings in parallel. Our team verifies benefits up front, confirms prior authorizations, and runs every claim through layered scrubbing before it leaves the building. With so many payers active in a market this size, a practice cannot afford to treat verification as an afterthought, and we make sure it never is.
- Eligibility and benefits verification for every payer type
- Precise medical coding across specialties
- Root-cause denial work and appeals
- Aggressive follow-up on aging accounts receivable
What Texas practice managers value most is visibility. You always know where a claim stands, why a denial happened, and what we are doing about it, so the business side of medicine stops feeling like a black box. Our reporting turns raw claim activity into something an owner can actually read and act on.
Growth brings its own billing pressures, and a group adding providers between Dallas and San Antonio needs credentialing that keeps up. We manage CAQH profiles and payer enrollments so newly hired clinicians start billing without a lull, and we keep those records current as contracts renew. From a solo office in Austin to a multi-site organization stretching across the state, the promise is consistent: cleaner claims, faster resolution on denials, and a revenue cycle sturdy enough to support whatever comes next.