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Credentialing services
in San Antonio, TX
Qualigenix enrolls San Antonio providers with Texas Medicaid, the Bexar County health plans, Medicare and commercial payers through our provider credentialing services.
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How Qualigenix serves San Antonio practices
Qualigenix credentials physicians and other clinicians for independent practices across San Antonio and Bexar County, using the statewide steps on our page for credentialing services in Texas. Texas Medicaid adds steps for San Antonio practices. A provider who wants to see Bexar Medicaid patients has to enroll with Texas Medicaid, then be credentialed by each managed care plan they want to join, then sign a contract with that plan. Qualigenix runs all three and tells you where each provider stands with each plan. You pay $99 per payer application, so the cost of adding a provider is known before we start.
What credentialing services does Qualigenix provide in San Antonio?
Qualigenix completes Texas Medicaid enrollment in PEMS, credentialing with the Bexar Medicaid plans, Medicare enrollment through PECOS, commercial payer applications and CAQH upkeep for San Antonio providers.
We report status for every payer until it decides, then track revalidation and re-credentialing dates.
Credentialing for Bexar County's Medicaid plans
Qualigenix enrolls each provider with Texas Medicaid first, then credentials them with the Bexar plans your practice wants to join. A plan can't pay a provider who isn't enrolled with the state.
STAR, CHIP and STAR Kids plans
HHSC's January 2026 map lists four STAR and CHIP plans in Bexar (Aetna, Community First, Superior and Wellpoint) and two STAR Kids plans (Superior and Community First). Superior also runs STAR Health for children in foster care statewide. Texas Medicaid plans don't each verify your credentials separately. All of them use the credentialing verification organization run by the Texas Association of Health Plans, which performs primary source verification once for every plan. Qualigenix submits the Texas Standardized Credentialing Application, answers the verification requests and follows each plan through its credentialing committee.
STAR+PLUS plans
STAR+PLUS in Bexar runs through Community First, Molina and United. Practices that see adults with disabilities or older adults often join all three. Qualigenix credentials each provider with each STAR+PLUS plan and tracks the shared three-year re-credentialing cycle, so one missed date doesn't drop a provider from every plan at once.
Texas Medicaid enrollment
Every Texas Medicaid provider enrolls through TMHP's Provider Enrollment and Management System (PEMS). Most providers revalidate every 5 years, and PEMS accepts a revalidation up to 120 days early. Qualigenix starts at that point. Statewide enrollment rules are covered in our guide to Texas Medicaid provider enrollment.
RESULTS ACROSS 275+ PRACTICES
Results San Antonio practices can expect
Qualigenix reports these figures across all client practices, not San Antonio alone.
12K+
Credentialing contracts managed
Up to 30% faster
Submission to approval
45-90 days
Payer approval window we work within
99%
Documentation & data-verification accuracy
To NCQA and CMS standards
Primary source verification
Managed on a 90-day cadence
CAQH re-attestation
Per payer
Status reporting
PROVEN TRACK RECORDHIPAA-Compliant Revenue Cycle
275+ ClinicsGETTING STARTED
How onboarding works
Qualigenix starts credentialing for a San Antonio practice in 6 days on average, following eight steps.
01
Data collection
We gather licenses, DEA, board certifications, malpractice coverage and work history.
02
Verification
We check each document at the source, to NCQA and CMS standards.
03
CAQH
We build or update each provider's CAQH ProView profile.
04
Applications
We file with Texas Medicaid in PEMS, the Bexar plans, Novitas and your commercial payers.
05
Contracts
We track each plan's contract and network participation after credentialing.
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WHY PRACTICES CHOOSE QUALIGENIX
Why San Antonio practices choose Qualigenix
Texas practices pick Qualigenix for credentialing for four reasons.
Priced per payer application ($99)
Each payer application costs $99. You know the total before we start, based on how many payers each provider needs.
One credentialing specialist per account
Your practice works with one named credentialing specialist who knows each provider's file and every open application.
Status reported for every payer
You see where each provider stands with each payer, from submission to decision, in one report.
Credentialing and billing in one company
Qualigenix also bills for practices, so enrollment dates line up with the first claim each provider sends.
HAVE QUESTIONS?
Frequently Asked Questions
Frequently asked questions about our setup and support in San Antonio.
Qualigenix is one of several companies that credential providers in San Antonio. We handle Texas Medicaid enrollment, Bexar plan credentialing, Medicare enrollment and commercial payers for $99 per payer application. Each account gets one named credentialing specialist. Call 786-259-0231 to talk to a credentialing specialist.
Qualigenix files the enrollment in TMHP's Provider Enrollment and Management System (PEMS). Once the provider is enrolled, we credential them with the Bexar plans your practice wants to join and track each plan's contract.
As of HHSC's January 2026 map, the Bexar Service Area has Aetna, Community First, Superior and Wellpoint for STAR and CHIP, Community First, Molina and United for STAR+PLUS, and Superior and Community First for STAR Kids. Superior also runs STAR Health for children in foster care statewide.
Yes. Qualigenix files Medicare enrollment through PECOS, and Novitas Solutions processes it as the Medicare contractor for Texas. We also complete Medicare benefit assignment and keep the enrollment current for Medicaid revalidation.
Qualigenix works within a 45-90 day payer approval window and follows up weekly or biweekly on every application. Payers make the final decision, and we report each status to you as it changes. Across clients, Qualigenix reports up to 30% faster submission to approval.
Qualigenix charges $99 per payer application, covering full provider credentialing and payer enrollment. Your total depends on how many payers each provider joins, so you know the cost before we file anything.
No. What matters is that your team knows PEMS, the Bexar plans and the Texas credentialing verification process. Qualigenix credentials providers in 48 states and manages 12K+ credentialing contracts. Applications, follow-up and status reports all run through one named specialist.