Texas has the second largest physician workforce in the country and a healthcare market shaped by its massive geography, diverse payer mix, and one of the most restrictive Medicaid programs in the nation. Billing correctly in Texas means knowing the difference between BCBS of Texas and other BCBS plans, understanding Texas Medicaid’s managed care organizations, and navigating the state’s balance billing regulations. Go Medical Billing serves practices in every major Texas metro and across rural communities statewide.
Texas Medicaid Managed Care
Texas runs its Medicaid program through managed care organizations including Superior HealthPlan, UnitedHealthcare Community Plan, Molina, Amerigroup, and Cook Children’s. Each MCO has its own claims submission rules, authorization requirements, and timely filing deadlines. We maintain active relationships with every Texas Medicaid MCO and submit claims according to each plan’s specific requirements.
BCBS of Texas
BCBS TX is one of the largest commercial payers in the state but operates differently from BCBS plans in other states. Fee schedules, prior auth rules, and appeal processes are specific to the Texas plan. Our team bills BCBS TX daily and knows their system inside out.
Texas Balance Billing Law (SB 1264)
Texas was one of the first states to pass comprehensive surprise billing legislation. SB 1264 affects out of network billing for emergency and certain non emergency services. Our team ensures your OON claims and patient billing comply with Texas state law alongside the federal No Surprises Act.
Large Uninsured Population
Texas has one of the highest uninsured rates in the country. That makes patient billing, payment plans, and charity care documentation more important here than in most states. We handle patient responsibility collections with professionalism and clear communication.
We serve Texas practices in cardiology, urology, urgent care, behavioral health, orthopedics, ABA therapy, DME, laboratory, pain management, internal medicine, and more. From Houston’s medical center to solo practices in West Texas, our team handles the full billing operation.
Starting at 2.49% of net collections. In Texas, a full time medical biller costs $38,000 to $52,000 in salary before benefits, office space, and software. Our rate covers an entire billing team for a fraction of that cost. Pay for paid model, no hidden fees.
Which Texas payers do you work with?
All of them. BCBS TX, Aetna, Cigna, UHC, Humana, Superior HealthPlan, Molina, Amerigroup, Medicare (Novitas Solutions), and every Texas Medicaid MCO.
Can you handle Texas Medicaid enrollment?
Yes. We manage Medicaid managed care credentialing for all Texas MCOs, including STAR, STAR+PLUS, and STAR Kids programs.
Do you work with rural Texas practices?
Absolutely. We serve practices in every Texas county. Rural practices often face unique billing challenges with payer mix and patient demographics. We understand those dynamics.
Call 888 701 6090 for a free Texas billing assessment.
