TEXAS · MEDICAL BILLING & REVENUE CYCLE MANAGEMENT
Medical Billing Services in Texas
A Texas medical billing company built around your practice — and around the shortest Medicaid filing deadline in the country.
Your team shouldn’t be choosing between patient care and chasing claims. BilNow handles revenue cycle management for Texas practices end to end — eligibility, coding, submission, denials, A/R, payment posting, credentialing and reporting — so the hours go back where they belong.
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TEXAS AT A GLANCE
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BilNow is a New York-registered medical billing company serving practices across Texas, providing full revenue cycle management to Texas practices: eligibility, coding, claim submission through TMHP and MCO portals, denial management, A/R recovery, payment posting, credentialing and reporting. Pricing is a percentage of collections (from 2.7%) with no setup fee, and every workflow is built around Texas payer rules — including the 95-day Medicaid filing deadline and the four STAR programs.
KEY TAKEAWAYS
- Texas Medicaid claims must be filed within 95 days of service — one of the shortest windows in the US.
- STAR, STAR+PLUS, STAR Kids and STAR Health each route to different MCOs across 13 service areas.
- FirstCare and RightCare exit STAR on August 31, 2026 — re-verify affected patients’ plans.
- BilNow works inside your existing EHR with a named team and transparent reporting.
REVIEWED FOR ACCURACY BY
Harris Mahmood — Director of RCM and Credentialing Operations, BilNow
Revenue cycle and credentialing operations lead. LinkedIn. Last reviewed: 17 September 2026. State regulatory facts on this page cite public agency and payer documentation.
Why Medical Billing in Texas Is Its Own Discipline
Texas isn’t a one-program Medicaid state — and the clock runs fast.
Texas runs one of the largest Medicaid managed care programs in the country, and it isn’t a single program. STAR, STAR+PLUS, STAR Kids and STAR Health each carry distinct enrollment, authorization and billing rules, and a patient’s program assignment decides which MCO portal and prior-auth list applies. Claims route through TMHP, and the Texas Medicaid Provider Procedures Manual changes monthly. Add Medicare, a BCBSTX-dominated commercial market, Medicare Advantage, workers’ comp and self-funded plans, and no single workflow fits every Texas payer.
The 95-day filing window
Texas Medicaid requires most claims to be filed within 95 days of the date of service — one of the shortest Medicaid deadlines in the United States. When day 95 lands on a weekend or holiday, TMHP extends it to the next business day. Practices that treat Texas like a 180-day state lose revenue that cannot be recovered. BilNow builds follow-up cadences around the actual Texas deadline, including rejection-and-correction cycles so a bounced claim is still refiled in time.
Thirteen service delivery areas
Texas divides Medicaid managed care into 13 service delivery areas, and the MCOs available differ by area. The same patient category can be assigned to different plans depending on where the practice sits. BilNow routes each claim by the member’s actual MCO assignment rather than a single statewide workflow.
A BCBS-dominant commercial market
Blue Cross Blue Shield of Texas, an HCSC plan, holds the largest commercial share statewide, with heavy Medicare Advantage enrollment across Houston, Dallas–Fort Worth, San Antonio and Austin. Each MA plan runs its own prior-auth and appeal rules. BilNow keeps commercial, MA and Medicaid workflows separate and organized.
Sources: Texas HHS — Medicaid managed care · TMHP provider manual (TMPPM) · Texas DWC — workers’ comp. Verify current rules with the payer before relying on any deadline.
WHAT CHANGED IN 2026
FirstCare and RightCare (Scott & White) health plans leave the Texas STAR program on August 31, 2026, per Texas HHS. Members in the Central Texas and West Texas/Lubbock service areas are being moved to other plans. If your practice sees these patients, verifying the new MCO assignment before billing avoids a wave of denials.
Your Practice Doesn’t Need Another Billing Vendor
You need a revenue cycle partner.
Submitting claims is one step. What happens before the claim — and after it’s rejected, underpaid, or sitting at 90 days in A/R — is where Texas practices actually lose money. BilNow connects the whole process, from the front desk through final payment and recovery, with one team that knows which questions to ask a Texas payer.
One team. One connected revenue cycle. Registration, eligibility, benefits, prior auth, charge capture, coding, scrubbing, submission, posting, denials, A/R, patient collections, credentialing and reporting — managed together, not handed between vendors.
Full-Service Medical Billing for Texas Providers
Everything your revenue cycle needs — built for how Texas payers actually behave.
Every service is delivered by experienced billers and coders working inside your existing EHR, with Texas payer rules — and the 95-day clock — built into the workflow.
Revenue leakage starts before the patient is seen. We verify coverage, benefits and authorization requirements up front, flag high-risk payers, and confirm the patient’s STAR program and MCO assignment so the claim goes to the right place the first time.
Experienced coders translate documented care into ICD-10-CM, CPT and HCPCS with the right modifiers, in specialty-specific workflows. Fewer coding errors up front means fewer avoidable denials and less of the filing window spent correcting.
Claims are validated and scrubbed before they leave, submitted electronically through TMHP or the appropriate MCO portal, and tracked for rejections. A rejected Texas Medicaid claim that isn’t caught and refiled fast is a claim that ages out.
A denial is a symptom. We investigate the reason — eligibility, coding, authorization, documentation, timely filing, coordination of benefits — correct it, manage the resubmission or appeal, and track the pattern so it doesn’t keep coming back. Check the payer’s deadline in our timely filing limits by payer and state before you resubmit.
Aging A/R drains cash quietly. We prioritize balances by age, payer and value, work underpayments and stalled claims, and turn a number on a report into a list your team can act on.
ERA/EOB and patient payments posted accurately and reconciled against claims, so contractual adjustments, underpayments and unposted amounts are visible instead of buried.
Clear statements, automated reminders and online payment options that make the patient-responsibility portion easier to collect — without damaging the relationship.
Authorization requirement checks, requests, documentation and status tracking, so a missing auth doesn’t become a denied claim weeks later.
Provider enrollment, CAQH, Medicare, Texas Medicaid and commercial payer applications, recredentialing and tracking — so credentialing doesn’t become your practice manager’s second job.
Texas Medicaid and Workers’ Compensation Billing
Two payer types Texas practices bill constantly — and that reward getting the workflow right.
Texas Medicaid Billing Support
Navigate STAR programs and TMHP with confidence
Medicaid billing in Texas depends on which program and MCO the patient is enrolled in. BilNow organizes eligibility, authorization, claims, posting, denials and A/R follow-up around the applicable STAR program rules and the 95-day deadline.
Texas Workers’ Compensation Billing
A different payer with a different workflow
Workers’ comp under the Texas Division of Workers’ Compensation has its own documentation, fee schedule and dispute process. BilNow supports claim submission, coding, documentation review, follow-up, denial management and A/R for practices treating injured workers.
How to Choose a Medical Billing Company in Texas
Six questions that separate a Texas-ready billing partner from a national template.
Most billing companies will say yes to everything. These questions surface whether they actually know Texas.
QUESTION 1
Do you track the 95-day Texas Medicaid deadline per claim?
If the answer is a generic “we monitor timely filing,” ask how they handle a claim rejected on day 88.
QUESTION 2
Which STAR programs and service areas have you billed?
STAR, STAR+PLUS, STAR Kids and STAR Health each need different MCO portals and auth lists.
QUESTION 3
Who exactly will work my account?
Ask for names and credentials. Rotating reps are how Texas-specific knowledge gets lost.
QUESTION 4
Can I keep my EHR?
A vendor that forces migration is optimizing for their workflow, not yours.
QUESTION 5
What does your reporting show me — and how often?
You should see claims, denials by payer, A/R aging and filing-risk any time, not in a monthly PDF.
QUESTION 6
How is pricing structured?
Percentage of collections aligns incentives. Setup fees, minimums and per-claim add-ons don’t.
BilNow vs. a Typical Billing Vendor
What Texas practices actually get — side by side.
| What matters | BilNow | Typical vendor |
|---|---|---|
| Texas payer rules | Workflows built per payer and program, with state deadlines tracked | One national template |
| Who works your account | A named team — billers, coders, an RCM lead, a billing manager | Rotating reps |
| Your EHR | You keep it; we work inside it | Migration to their system |
| Reporting | Claims, denials, A/R, DSO and filing risk, visible any time | A monthly PDF |
| Pricing | Percentage of collections, no setup fee, no long-term contract | Setup fees, minimums, per-claim add-ons |
| Content you’re reading | Reviewed by a named operations lead with a verifiable profile | Anonymous marketing copy |
Specialty-Specific Billing for Texas Practices
Your specialty deserves more than a generic workflow.
The codes you use, the authorizations you need and the payers you deal with all change by specialty. BilNow builds the billing workflow around yours.
Pain Management
Injections, RFA, implants and E/M with authorization-heavy payer workflows.
Orthopedics
Surgical, fracture care, DME and PT claims across Texas MA and commercial plans.
Behavioral Health
Behavioral and mental-health services with STAR-specific requirements.
Cardiology
Diagnostics, procedures and E/M coding for cardiovascular practices.
Urgent Care
High-volume, multi-payer claims with fast turnaround expectations.
Internal Medicine
E/M, preventive and chronic care management billing.
Also serving:
Don’t see your specialty? Ask our billing team →
Your EHR. Our Billing Expertise.
Don’t change your EHR just to change your billing company.
You’ve already invested in your technology. BilNow works inside major EHR and practice-management platforms so your providers keep their workflow while the revenue cycle improves behind it.
Know What Your Texas Revenue Cycle Is Doing
Your billing company shouldn’t be a black box.
You should be able to see what’s happening with your money — including how many Texas Medicaid claims are approaching day 95.
Submitted, rejected, pending, paid
Reasons, trends, repeat payer issues
Balances and aging by payer
Performance over time
Posting and reconciliation
Days sales outstanding trend
Claims nearing Texas deadlines
Underperforming codes
Texas Medical Billing Glossary
Terms you’ll see on EOBs, portals and payer letters in Texas.
- TMHP
- Texas Medicaid & Healthcare Partnership — the claims administrator and provider portal for Texas Medicaid fee-for-service and enrollment.
- STAR / STAR+PLUS / STAR Kids / STAR Health
- The four Texas Medicaid managed care programs. Each has its own eligibility, MCO roster and authorization rules.
- Service Delivery Area (SDA)
- One of 13 geographic regions that determine which MCOs a Texas Medicaid member can be assigned to.
- TMPPM
- Texas Medicaid Provider Procedures Manual — updated monthly; the authoritative source for billing rules.
- 95-day timely filing
- The Texas Medicaid deadline to submit a claim, counted from the date of service; missed claims are unrecoverable.
- MCO
- Managed Care Organization — the health plan (e.g., Superior, Molina, Amerigroup) that pays claims for STAR members.
One Dedicated Team for Your Revenue Cycle
You should know who is working on your billing.
Billing specialists run your day-to-day. Experienced coders handle specialty coding. RCM experts watch the broader cycle. A billing manager owns oversight and communication. Real names, real credentials.
How the Transition Works
A simple move from your current billing process to BilNow.
Specialty, providers, payer mix, EHR, claim volume, current setup.
Gaps, bottlenecks and revenue opportunities — including Texas deadline exposure.
A workflow around your practice, not a template.
Working inside your existing EHR and PM environment.
The services in your engagement, run by a named team.
Claims, denials, A/R, payments and KPIs, transparently.
Recurring patterns turned into fixes over time.
Serving Healthcare Providers Across Texas
From Houston to Dallas–Fort Worth to the Valley.
BilNow supports practices throughout Texas, including:
Your location may be Texas. Your revenue cycle is still unique to your practice.
Texas Payer Rules at a Glance: Medicaid Filing Deadline and Medicare MAC
Texas Medicaid has one of the shorter filing windows a practice will meet, and Medicare Part B claims go to a different contractor than in most neighboring states. Each fact below links to the agency page it comes from.
| Medicaid claims processor | Texas Medicaid fee-for-service claims are filed with TMHP (Texas Medicaid and Healthcare Partnership). Source: TMHP, Texas Medicaid Provider Procedures Manual, Section 6: Claims Filing. |
|---|---|
| Medicaid timely filing | TMHP must receive claims within 95 days of the date of service on the claim. Source: TMHP. |
| Out-of-state providers | TMHP must receive claims from out-of-state providers within 365 days from the date of service. Source: TMHP. |
| Medicare MAC (Part A and B) | Novitas Solutions, Inc., A/B MAC Jurisdiction H (JH), which covers Texas along with Arkansas, Colorado, Louisiana, Mississippi, New Mexico and Oklahoma. Source: CMS, A/B MAC Jurisdiction H. |
| State rule that shapes billing | The 95-day Medicaid window is measured from the date of service, not from the date a claim is adjudicated or a denial is received, so front-end eligibility and charge capture have to be fast. Source: TMHP. |
In practice a Texas Medicaid claim that sits in a coding queue for three months is already at risk, which is why BilNow works charge capture and claim submission daily. Deadlines for other payers are tracked on our timely filing limits page. Last checked against the cited sources on 3 October 2026; always confirm current rules with the payer.
Related: medical billing · medical coding · credentialing · denial management · A/R recovery · prior authorization · pricing · timely filing limits by payer · denial code lookup · Florida billing · Georgia billing · orthopedic billing · mental health billing services.
Frequently Asked Questions
Do you work with Texas Medicaid and the STAR programs?
Yes. BilNow supports practices billing Texas Medicaid through STAR, STAR+PLUS, STAR Kids and STAR Health. Because each program and MCO has its own portal, prior-authorization list and rules, accurate program assignment at intake matters more in Texas than almost anywhere else.
How do you handle the 95-day Texas Medicaid filing deadline?
We track every Texas Medicaid claim against the 95-day window from date of service and build rejection-and-correction follow-up so a claim that bounces still gets refiled in time.
Which Texas MCOs do you work with?
MCO availability differs across 13 service delivery areas. BilNow works with the plans active in your area — including Superior HealthPlan, Molina, UnitedHealthcare Community Plan, Amerigroup and Texas Children’s Health Plan — and routes each claim by the member’s actual assignment.
Do you handle Texas workers’ compensation billing?
Yes. BilNow supports workers’ comp claims, coding, documentation, follow-up, denials and A/R for Texas practices treating injured workers.
Can BilNow work inside our existing EHR?
Yes. We work with athenahealth, eClinicalWorks, AdvancedMD, Kareo (Tebra), NextGen and many others. The exact workflow is set during onboarding.
Do you provide credentialing for Texas payers?
Yes. Provider enrollment, CAQH, Medicare, Texas Medicaid and commercial payer credentialing and recredentialing are core services.
Can you work our old A/R?
Yes. Aged A/R recovery is part of the engagement — prioritized by age, payer and value.
Does BilNow serve practices in Texas?
Yes. BilNow serves practices across Texas, with billing support across the state.
How much does medical billing cost in Texas?
Pricing depends on specialty, provider count, claim volume and services required. BilNow offers a transparent percentage-of-collections model starting at 2.7% for qualifying practices, with no setup fee — request a practice-specific quote.
How do I get started?
Start with a free billing audit or a conversation about your practice. We’ll look at your current operation, identify opportunities, and show you what working with BilNow looks like.
Which Medicare Administrative Contractor processes Medicare claims in Texas?
Novitas Solutions, Inc. is the A/B MAC for Jurisdiction H, which includes Texas, according to CMS. BilNow submits Texas Medicare Part B claims to Novitas and follows them through remittance.
How does BilNow price medical billing in Texas?
BilNow charges 2.7% of collections, with no setup fee and no long-term contract. The pricing page shows how the percentage works.
What is the Texas Medicaid claims filing deadline?
The TMHP provider manual states that TMHP must receive claims within 95 days of the date of service, and within 365 days for out-of-state providers. See the timely filing limits page for other payers.
Where is BilNow based, and does it serve Texas?
BilNow is headquartered at 430 Fifth Avenue, New York, NY 10018, and serves Texas practices, including those in Houston, Dallas, San Antonio, Austin, Fort Worth and El Paso.
How does BilNow help Texas practices avoid missing payer deadlines?
BilNow tracks each claim against the payer’s filing window from the date of service and works rejections and denials quickly through denial management and A/R recovery. You can also look up denial reasons in the denial code lookup.
Ready to Take Control of Your Texas Medical Billing?
Your practice is built around patient care. Your revenue cycle should be built around getting you paid.
You shouldn’t spend your day chasing claims. Your providers shouldn’t worry about billing. Your practice manager shouldn’t have to become a full-time revenue-cycle specialist. BilNow handles the work behind the revenue.
MEDICAL BILLING ACROSS THE US