Texas has more active physicians per capita than almost any other state, which means competition is sharp and payer expectations are strict. BlueCross BlueShield of Texas, UnitedHealthcare, Aetna, Humana, and Medicaid managed care organizations like Molina and Centene all operate under their own submission rules, timely filing windows, and pre-authorization requirements. One missed deadline or a single coding mismatch can hold up payments for weeks. At My Physician Billing, we work with Texas physicians, clinics, and group practices across Houston, Dallas, San Antonio, Austin, and beyond. Our team understands the specific payer landscape in this state — not just the national billing guidelines, but the Texas-specific nuances that trip up billing departments every month.
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Texas has one of the most complex payer mixes in the country. Solo and small-group practices here often deal with challenges that don't exist in the same form anywhere else.
Texas contracts Medicaid through managed care organizations instead of running a centralized fee-for-service program. Each MCO — Molina, Centene, CHRISTUS Health Plan, and others — has its own portal, prior authorization rules, and claim submission format. A claim correctly submitted to one MCO may be denied by another
Texas has one of the highest uninsured rates in the US. Practices often see patients with coverage gaps, which means more charity care documentation, more coordination between payers, and more write-off decisions that need to be handled thoughtfully and in compliance with billing regulations.
Physicians serving Medicaid patients through STAR or STAR+PLUS encounter additional credentialing and billing requirements that don't exist in standard commercial billing. These need to be handled carefully to avoid retroactive claim recoupments. Our Texas billing team handles all of this as part of the standard service — not as an add-on.
Running a medical practice in Texas is demanding enough without chasing down unpaid claims or decoding payer denials. My Physician Billing handles that work so your team can stay focused on patients. Schedule a free, no-obligation billing review with our Texas team today.
Billing rules vary significantly by specialty, and we have developed billing workflows for the most common practice types in Texas:
If your specialty is not listed above, contact us — we are likely already billing for similar practices and can confirm scope during a free consultation.
We manage your complete revenue cycle from the day a patient walks in to the day the final payment posts.
We verify insurance coverage and benefits before the patient's visit so your front desk isn't discovering coverage problems at checkout. Texas MCO eligibility in particular can change month to month, so this step prevents a significant share of
Our certified coders handle CPT, ICD-10, and HCPCS coding for your specific specialty. Whether you practice internal medicine in Houston, cardiology in Dallas, or chiropractic care in San Antonio, we assign coders who understand your documentation
Once we receive your encounter data, clean claims go out the same business day. Speed matters in Texas billing because several commercial payers here have timely filing limits as short as 90 days. Every day a claim sits unsubmitted is a day closer to the filing deadline.
When a claim comes back denied, our team reviews the EOB, identifies the actual root cause — whether it's an authorization gap, a coding mismatch, or a payer-specific billing rule — and resubmits with the correct documentation. We do not batch-refile denials and hope for the best. Each one is reviewed individually.
ging AR is one of the clearest signs that a billing process has broken down. We follow up with payers at the 15-day mark on unpaid claims and escalate at 30 days. Our goal is to keep your average AR days below 30, compared to the industry average of 45 or more.
We generate clear, easy-to-read patient statements and handle follow-up on outstanding balances professionally. Patient-facing billing is a part of your practice's reputation — we handle it accordingly.
Not every practice needs the same level of billing support. In our experience working with Texas providers, these are the situations where outsourcing produces the clearest improvement: Practices with more than 15% of claims coming back denied on first submission are leaving money on the table that a better billing process can recover. Practices running in-house billing with one or two staff members face serious revenue disruption when that person is sick, on leave, or leaves the job. Practices that recently expanded, added a new provider, or opened a second location often find their existing billing setup cannot handle the added volume cleanly. And practices that have not done a billing audit in the last 12 months are almost certainly under-collecting on at least some codes. We offer a no-cost billing review for Texas practices before you commit to anything. We look at your denial rate, your AR aging, your coding patterns, and your payer mix — and give you an honest assessment of where the leaks are.
FaqsFor most practices, we can have your billing fully transitioned within 7 to 14 business days. The process involves gathering your current payer contracts, credentialing information, EHR access, and outstanding AR details. We work in parallel with your current billing setup during the transition so there is no gap in claim submissions.
Yes. We are familiar with the Texas STAR and STAR+PLUS programs and work with all major Texas MCOs including Molina Healthcare of Texas, Centene/Superior HealthPlan, CHRISTUS Health Plan, and Community Health Choice. Each MCO has different portal requirements and prior authorization processes, and our team handles those differences as part of standard service.
We charge a percentage of collected revenue — typically between 4% and 7% depending on your specialty, claim volume, and practice size. You pay only when you get paid. There are no setup fees, no hidden charges, and no long-term contracts.
Yes, we can support your in-house biller with denial management and AR follow-up specifically, or we can take over the full billing cycle. Many Texas practices start with denial recovery and AR clean-up, see the improvement in collections, and then transition full billing to us. We adapt to what your practice needs.
Each denied claim is reviewed individually for the actual denial reason — not just the denial code. We check authorization requirements, payer-specific billing rules, and documentation completeness before resubmitting. For BCBS of Texas specifically, we are familiar with their NaviMedix pre-auth system and claim review protocols.
