Texas Medical Billing Services

Texas has one of the most demanding healthcare environments in the United States. More than 30 million residents, over 13% aged 65 and older on Medicare, and the highest uninsured rate in the country all contribute to a complex billing landscape. Major cities such as Houston, Dallas, San Antonio, and Austin process enormous claim volumes, while rural and suburban providers often face the same payer complexity with fewer administrative resources. Adding to the challenge, Texas has not expanded Medicaid, which creates additional difficulties in collections and revenue stability.

MZ Medical Billing provides outsourced medical billing services for Texas providers. On average, our clients experience:

20–30% fewer claim denials
10–15% faster reimbursements
Up to 25% improvement in overall collections

From Medicare and Medicaid managed care to commercial payers, out-of-state insurers, and uninsured patient billing, our team manages the entire revenue cycle, coding, claim submission, denial management, patient statements, and collections. With our outsourced expertise, Texas practices, clinics, and hospitals can keep revenue flowing while focusing fully on patient care.

Texas Medicaid and Uninsured Billing Headaches? We’ll Handle It

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98%
Claim Approval Rate

97%
First pass Ratio

<30
Days in AR

96%
Collection Ratio

Why Outsource Texas Medical Billing to
MZ Medical Billing

MZ Medical Billing is a trusted Texas medical billing services provider serving physicians, clinics, and healthcare facilities across the Texas state. Many providers choose to outsource Texas medical billing to us because it reduces overhead costs, improves claim accuracy, and frees staff from time-consuming administrative work. As a professional Texas medical billing firm, our Certified Professional Billers (CPB®) manage the complete revenue cycle, including patient registration, insurance verification, CPT/ICD-10 coding, claim submission, payment posting, and Accounts Receivable (AR) follow-up. With a 98% clean claims rate and up to 30% fewer AR days, our clients recover revenue faster and cut down on write-offs.

Our medical billing services in Texas cover more than just claim submissions. We also provide:

Specialty-specific billing expertise for cardiology, orthopedics, dermatology, mental health, family medicine, and multi-specialty practices common across Texas.
AR recovery solutions to help practices collect on old and denied claims.
Revenue cycle audits to uncover missed charges, underpayments, and compliance risks.
Custom reporting to give administrators and physicians a clear view of financial performance.
Expert knowledge of Texas payers and compliance, including Medicare (Novitas Solutions), Texas Medicaid, and leading insurers such as Blue Cross Blue Shield of Texas, UnitedHealthcare, and Aetna.
Experience with telehealth and Medicaid managed care billing in Texas, ensuring compliance with state-specific requirements.

By outsourcing Texas medical billing to MZ Medical Billing, providers gain a partner who delivers compliance, accuracy, and financial insight—helping practices strengthen collections, protect margins, and plan for growth.

What We Offer

Our Texas Medical Billing Services

Texas medical practices lose revenue every year when claims are rejected or delayed. Nationally, up to 25% of claims are denied at first submission, many for preventable issues such as coding errors, missing documentation, or eligibility mistakes. In Texas, providers face additional challenges with one of the nation’s largest Medicaid managed care programs (serving over 5 million Texans through MCOs like Superior HealthPlan, Molina, and Amerigroup) and with Medicare, where Novitas Solutions is the regional MAC and Medicare Advantage now covers more than half of Texas beneficiaries.

MZ Medical Billing brings proven systems and measurable results to Texas medical billing. Our clients typically see a 20–30% reduction in claim denials, 10–15% faster reimbursements, and up to 25% improvement in overall collections after partnering with us. We also maintain a 98% clean claims rate and up to 30% fewer AR days, helping providers improve cash flow and reduce write-offs.

By outsourcing Texas medical billing to MZ Medical Billing, practices gain:

Stronger collections across Medicaid and Medicare Advantage
Faster claim turnaround
Fewer write-offs
and actionable financial reporting to support better business decisions.

These results are possible because we don’t just process claims—we deliver a full suite of Texas medical billing services, including denial management, AR recovery, specialty-specific billing, revenue cycle audits, patient billing support, and compliance with TMHP and HHSC requirements.

Below are our specialized services designed to support Texas healthcare providers:

Medical Billing Services

We manage your entire billing process from start to finish, submitting accurate and timely claims to Texas insurance carriers. Our billing experts apply Texas prompt pay laws and payer-specific requirements to help practices increase cash flow, reduce A/R costs, and stay compliant with Texas Department of Insurance (TDI) guidelines.

Medical Practice Audit Services

We review billing and coding practices for compliance with federal and Texas regulations, including TMHP and HHSC requirements. Audits uncover errors, underpayments, and compliance risks—helping your practice improve collections and lower audit exposure.

Accounts Receivable (AR) Recovery Services - Icon

Outsource Prior Authorization Services

In Texas, many procedures require prior authorization from Medicaid MCOs or commercial insurers such as BCBS of Texas, UnitedHealthcare, and Aetna. We manage the process end-to-end, obtaining approvals quickly to prevent care delays and speed up claim payments.

Medical Coding Services

Our certified coders work with CPT, ICD-10, and HCPCS coding. Coding is aligned with both national standards and TDI updates, reducing compliance risks and supporting faster reimbursements from Medicare, Medicaid, and Texas-based commercial insurers.

Revenue Cycle Management

We handle the full revenue cycle—from patient intake and insurance verification to payment posting and reporting. For Texas providers, we align processes with Medicare Advantage, Medicaid managed care, and local payer rules to reduce denials and accelerate payments.

Denial Management

When Texas payers deny claims, we investigate the root cause, correct errors, and resubmit or appeal. Our team is experienced with Texas payer appeal and dispute requirements, helping turn denials into revenue while maintaining compliance.

Provider Credentialing Service

We manage credentialing and enrollment with Texas Medicaid, Medicare, and leading commercial insurers. Our team handles documentation and follow-up so providers are properly enrolled and able to bill without administrative delays.

Credentialing and Contracting Services - Icon

Insurance Verification Services

We confirm patient coverage with Texas-based insurers before services are delivered. This prevents claim denials and protects patients under Texas balance billing protections and prompt pay rules.

Payment Posting

We record payments from patients and insurers, including ERAs and EOBs, with full accuracy. Clean posting keeps your Texas practice’s financial data correct, traceable, and audit-ready.

Accounts Receivable (AR) Recovery

We work old and unpaid claims aggressively. By analyzing Texas aging reports, we recover revenue tied up in unresolved claims and reduce healthcare A/R costs.

Practice Management Services

We support practice operations through workflow reviews, staff training, and technology setup. For Texas facilities, we align management practices with state payer regulations and reimbursement requirements.

OLD AR cleanup

Our team focuses on aged receivables, reviewing accounts line by line to recover revenue that might otherwise be written off. This service targets unpaid Texas claims to restore lost cash flow.

Telehealth Billing

Texas has made telehealth coverage permanent, but billing rules vary by payer. We code and submit telehealth claims in line with Texas Medicaid, Medicare Advantage, and commercial insurer policies so providers are reimbursed properly.

Healthcare Digital Marketing/SEO

We help Texas practices attract patients through local search visibility. Strategies are designed for the Texas healthcare market, driving patients searching for providers in your area.

Appeals and Disputes Management

We prepare documentation, follow Texas payer rules, and manage appeals until resolved. Our team has hands-on experience with Texas insurer dispute processes.

Patient Billing Services

We handle patient statements, set up payment plans, and provide billing support. All communications comply with Texas consumer protection laws, helping patients understand their bills and lowering disputes.

Patient Help Desk (PHD)

We provide a billing help desk for patients, answering questions directly and reducing the load on your staff. Patients in Texas receive clear, accurate information about their bills.

Medical Billing Write-Offs Recovery

We review billing workflows to identify unnecessary write-offs and recover revenue that could have been lost. For Texas practices, this strengthens collections and protects margins.

Our Medical Billing Process for Texas Practices

Step 1: Patient Demographics & Insurance Verification

We begin by capturing accurate patient demographics and verifying insurance eligibility before care is provided. In Texas, this includes working with Medicaid managed care organizations (MCOs) such as Superior HealthPlan, Amerigroup, and Molina Healthcare, along with Medicare through Novitas Solutions (the Texas MAC) and major commercial carriers like BCBS of Texas, UnitedHealthcare, Aetna, Cigna, and Humana.

Step 2: Charge Capture & Accurate Coding

Our certified coders apply the latest ICD-10, CPT, and HCPCS codes, including payer-specific modifiers required by Texas insurers. Accurate coding reduces denials, particularly in high-volume specialties common in Texas such as cardiology, orthopedics, dermatology, and behavioral health.

Step 3: Claims Scrubbing & Submission

Each claim is checked against payer edits using advanced scrubbing tools before submission. Claims are then transmitted electronically to Medicare (via Novitas), Medicaid (TMHP/HHSC), and commercial payers. Our Texas billing team maintains a 98% clean claims rate, reducing delays and speeding reimbursements.

Step 4: Payment Posting & Reconciliation

Payments are posted promptly, and Electronic Remittance Advice (ERA) is reconciled with expected reimbursements. Texas practices receive real-time reporting by payer, allowing quick detection of underpayments or payer-specific trends.

Step 5: Denial Management & Appeals

We categorize denials by reason, correct errors, and prepare appeals with full medical documentation. Appeals are submitted following Texas Department of Insurance (TDI) rules, HHSC requirements, and CMS standards, helping recover revenue that often goes uncollected in-house.

Step 6: Accounts Receivable (AR) Follow-Up

Our AR specialists pursue unpaid claims with a focus on aged AR beyond 60–90 days. We specifically target backlogs with Medicaid MCOs and Medicare Advantage payers, helping Texas practices cut AR days by up to 30%.

Step 7: Patient Billing & Collections

We provide clear patient statements and structured payment options. All communications follow Texas consumer protection and balance billing laws, reducing disputes and strengthening collections.

Step 8: Compliance & Reporting

At every stage, we maintain compliance with HIPAA, CMS guidelines, TDI regulations, and Texas Medicaid & Healthcare Partnership (TMHP) rules. Practices receive detailed financial reports to support audits, payer negotiations, and long-term planning.

Meet Our Expert Texas Medical Billing Team

Our Texas billing team has extensive experience working with the state’s payer environment, Medicaid managed care complexities, and strict compliance requirements. Beyond coding and claims, we help providers stay aligned with Texas Medicaid (TMHP/HHSC), Medicare through Novitas, and commercial payer rules that directly affect collections.

Expert Skill	What We Do
Texas Medicaid & MCO Expertise	We work with Texas Medicaid and managed care plans such as Superior HealthPlan, Amerigroup, Molina, and UnitedHealthcare Community Plan, resolving eligibility issues, prior authorizations, and carve-outs.
Commercial Payer Relations	Our team has strong working relationships with Texas’s largest insurers, BCBS of Texas, UnitedHealthcare, Aetna, Cigna, and Humana, allowing faster communication and issue resolution.
Regulatory Compliance	We guide practices through Texas Department of Insurance (TDI) prompt pay laws, balance billing protections, HHSC/TMHP rules, and CMS compliance, reducing penalties and regulatory risks.
Revenue Insights	We provide Texas-specific benchmarking and reimbursement analytics, highlighting payer denial trends, underpayment risks, and Medicare Advantage patterns across the state.

The Importance of Outsourcing Medical Billing for Texas Practices

Running a healthcare practice in Texas is a lot of work. You focus on helping patients, but who focuses on getting you paid? That’s where outsourcing medical billing comes in. It’s about letting experts handle the money side of your business.
When should you think about hiring a medical billing company? If you’re spending too much time on paperwork, dealing with denied claims, or not getting paid on time, it’s a good sign that outsourcing can help.

Reduce A/R Healthcare costs: When billing is done right, less money gets lost or delayed.
Increase cash flow: You get paid faster and more consistently.
It saves you time and resources that you can use to focus on your patients.
Our team has deep knowledge of Texas healthcare rules and enhanced compliance with Texas regulations. This means fewer mistakes and more payments

We Are Among the Best in Texas

At MZ Medical Billing, we go beyond claim submission and follow-up. Our services are built specifically for the needs of Texas healthcare providers, with a focus on compliance, payer relations, and financial performance.

Expertise with Texas-Specific Programs

We handle TMHP claims, STAR/STAR+PLUS/STAR Kids managed care plans, and CHIP billing. Our team understands the unique requirements of Medicaid MCOs in Texas and helps practices avoid common delays with eligibility checks and authorization errors.

Local Knowledge of Commercial Networks

Texas has one of the most complex commercial payer landscapes. We work directly with Blue Cross Blue Shield of Texas, Aetna, UnitedHealthcare, Cigna, and regional carriers to resolve disputes, negotiate escalations, and track underpayments.

Audit-Ready Documentation

Texas providers often face audits from HHSC and RAC contractors. We prepare billing and coding documentation that stands up to scrutiny, reducing audit exposure and protecting revenue.

Rural and Urban Practice Support

Whether you’re a rural clinic billing for critical access hospital services or a specialty group in Dallas, Austin, or Houston, our billing systems adapt to the needs of your practice setting.

Appeals and Denial Management

We don’t stop at first-level denials. Our specialists pursue multi-level appeals with Texas payers, leveraging state-mandated prompt pay laws to overturn wrongful denials and secure revenue.

Proactive Revenue Strategy

We provide payer mix analysis, fee schedule reviews, and reimbursement benchmarking specific to Texas. This allows providers to see where they may be losing revenue and how to negotiate better contracts.

Medical Billing Services for Wide Range of Healthcare Specialties in Texas

Our Texas medical billing company supports physicians, clinics, and hospitals across the state’s most in-demand specialties. From Houston’s cardiology and orthopedic practices to mental health providers in Dallas and therapy clinics in San Antonio and Austin, we manage billing with specialty-specific coding, payer rule expertise, and revenue cycle oversight.

We work with:

Therapy providers – speech, occupational, and physical therapy billing for Texas’ large rehab and senior care population.
Mental health practices – psychiatry, psychology, and counseling billing that meets payer-specific requirements.
Family medicine and primary care – accurate coding and claim submission for diverse urban, rural, and community clinics.
Cardiology, dermatology, and orthopedics – high-volume specialty billing for Texas’ busy metropolitan and regional centers.

By outsourcing medical billing services to MZ Medical Billing, providers across specialties gain higher first-pass claim acceptance, fewer denials, and stronger collections.

Applied Behavior Analysis

Behavioural Health

Pediatric

Mental Health

Physical Therapy

Occupational Therapy

Speech Therapy

Anesthesiology

MZ Medical Billing can handle every medical billing software used by providers across Texas

Transform Your Texas Medical Practice Today!

Your focus is patient care, ours is getting you paid. At MZ Medical Billing, we handle Texas Medicare, TMHP Medicaid, and major insurers like BCBS, Aetna, and UnitedHealthcare. With expertise in Texas prompt pay laws and TDI compliance, we help practices cut denials, speed up payments, and strengthen cash flow.

FAQS

Frequently Asked Questions.

How is medical billing in Texas different from other states?

Texas has unique challenges, including Medicaid managed care through multiple MCOs, prompt pay laws regulated by the Texas Department of Insurance (TDI), and Medicare billing under Novitas Solutions as the regional MAC. These rules make billing more complex compared to many other states.

What is Texas Medicaid and how does it affect billing?

Texas Medicaid includes fee-for-service and managed care programs like STAR, STAR+PLUS, and CHIP. Each MCO (Superior, Amerigroup, Molina, etc.) has its own rules for claims and prior authorizations, requiring careful management.

Do you handle Texas Medicare Advantage billing?

Yes. We work with major Medicare Advantage carriers in Texas, including UnitedHealthcare, BCBS of Texas, Aetna, and Humana, handling plan-specific requirements to avoid denials.

Are Texas Medicaid MCOs harder to bill than commercial payers?

Yes. MCOs often require additional prior authorizations, strict documentation, and have higher denial rates compared to commercial carriers. Our team specializes in managing these complexities.

How does MZ Medical Billing stay compliant with Texas healthcare laws?

We follow Texas prompt pay laws, Medicaid/TMHP requirements, and TDI regulations. Our processes are designed to meet all state-specific billing and compliance rules.

What specialties in Texas benefit most from outsourcing billing?

Therapy providers, mental health practices, primary care, cardiology, dermatology, orthopedics, pediatrics, and multi-specialty clinics often see the greatest benefit due to payer-specific billing rules in Texas.

Can MZ Medical Billing help with old Texas Medicaid or commercial claims?

Yes. We provide AR cleanup and appeals services to recover revenue from old or denied claims, even those often written off by in-house teams.

How fast can a Texas practice start with MZ Medical Billing?

Most practices can transition within 2–4 weeks, with no disruption to cash flow during onboarding.

Why should Texas providers outsource medical billing?

Outsourcing saves time, reduces denials, and improves collections. With our knowledge of Texas-specific payer rules and regulations, providers gain stronger cash flow and fewer compliance risks.

We Serve All 50 States