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Medical billing services
in Austin, TX
Qualigenix bills every payer an Austin practice sees, from Travis County Medicaid plans to Medicare and commercial carriers.
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How Qualigenix serves Austin practices
The Qualigenix medical billing services team works the full claim cycle for independent practices in Austin and the nearby counties of the Travis Medicaid service area, including Williamson and Hays. Austin's payer mix comes from three groups: Texas Medicaid managed care plans, Medicare and state-regulated commercial HMOs and PPOs. Qualigenix bills all of them. Statewide rules, like the Texas Medicaid filing window, live on our medical billing services in Texas page. This page covers what changes for an Austin practice: which Medicaid plans operate in Travis County, how dual-eligible patients are billed here and how Qualigenix sends each claim to the right payer the first time.
What medical billing services does Qualigenix provide in Austin?
Qualigenix provides full medical billing for Austin practices: charge entry, coding, claim scrubbing and submission, denial appeals, A/R follow-up, payment posting and patient statements.
We bill all payers, including the STAR, STAR+PLUS, STAR Kids and CHIP plans in Travis County, Medicare through Novitas and commercial plans. Pricing is a percentage of collections.
Medical billing for Travis County's Medicaid plans
Texas runs most Medicaid through managed care. Travis County sits in the Travis service area with Bastrop, Burnet, Caldwell, Fayette, Hays, Lee and Williamson counties, and HHSC's January 2026 plan list sets which plans a patient can carry here. Qualigenix checks the plan on file before every claim goes out.
STAR and CHIP claims sent to the right plan
Three plans hold STAR and CHIP members in Travis County: Blue Cross and Blue Shield of Texas, Superior HealthPlan and Dell Children's Health Plan. A patient who switches plans mid-year sends the next claim to a different payer, and a claim filed with the wrong plan still uses up time on the Medicaid filing clock. Qualigenix verifies the plan before the visit and records it by date of service. When a plan rejects a claim as not its member, our team refiles it with the correct plan inside the same window and notes the change on the patient account so the next claim goes to the right place.
STAR+PLUS and STAR Kids claims
STAR+PLUS covers adults with disabilities and adults 65 and older. In Travis County the plans are Superior and UnitedHealthcare Community Plan. STAR Kids covers children and young adults 20 and younger with disabilities, through Blue Cross and Blue Shield of Texas or Superior. Many STAR+PLUS members also have Medicare, so the Medicaid plan pays second. Qualigenix bills the Medicare side first, posts that payment, then sends the balance to the STAR+PLUS plan with the primary remittance attached. STAR Kids services often run on authorizations, so our billers match each claim to the approved units before it's sent.
Texas Medicaid billing rules statewide
Rules that apply across the state, such as the 95-day filing deadline counted from each date of service, are covered on our Texas Medicaid billing rules page. Austin claims follow those same rules. What's different here is the set of plans a patient can carry.
RESULTS ACROSS 275+ PRACTICES
Results Austin practices can expect
These are Qualigenix company-wide results across 275+ practices onboarded, not Austin-only figures. Your numbers will depend on your specialty, payer mix and starting A/R.
98.2%
First-pass clean claim rate
4.8%
Denial rate
97.7%
Net collections rate
Reduced from 54 to 36
Days in A/R
79%
Denials overturned
$923M+
Revenue recovere
PROVEN TRACK RECORDHIPAA-Compliant Revenue Cycle
275+ ClinicsGETTING STARTED
How onboarding works
Qualigenix onboards an Austin practice in 6 days on average.
01
Discovery call
we review your specialty, payer mix and current billing reports.
02
System access
you give our team access to your EHR and clearinghouse. Qualigenix works in 133 EMR/EHR platforms.
03
Payer setup
we confirm your enrollment with each Travis County Medicaid plan, Novitas and your commercial payers.
04
Open A/R review
we sort open claims by filing deadline so nothing ages past a payer's window.
05
Go-live
new claims start flowing, and monthly reports begin the first month.
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WHY PRACTICES CHOOSE QUALIGENIX
Why Austin practices choose Qualigenix
Texas practices pick Qualigenix for four reasons.
Specialty-assigned coders
Your claims are coded by CPC- and CCS-certified coders who work in your specialty every day. That keeps coding accuracy at 98.9% and cuts the rework that delays payment.
Works with any EHR
Qualigenix works inside the system you already use. We support 133 EMR/EHR platforms, so your staff keeps its current workflow and nothing gets migrated.
Transparent monthly reporting
Every month you get collections, denials and A/R by payer, including each Travis County Medicaid plan. You can see which payer is slow and what we're doing about it.
6-day average onboarding
Most practices go live in 6 days. We sort your open A/R by filing deadline first, so old claims don't age out during the switch.
HAVE QUESTIONS?
Frequently Asked Questions
Frequently asked questions about our setup and support in Austin.
Qualigenix provides medical billing for independent practices in Austin and across Texas, covering all payers. We bill Travis County Medicaid plans, Medicare through Novitas and commercial plans. Talk to a billing specialist to see how we'd handle your payer mix.
Yes. Qualigenix bills all Travis County Medicaid plans, including Blue Cross and Blue Shield of Texas, Superior HealthPlan, Dell Children's Health Plan and UnitedHealthcare Community Plan. We confirm each patient's plan before the claim goes out.
Qualigenix bills Medicare or the patient's Medicare plan first, posts that payment, then sends the remaining balance to the patient's STAR+PLUS plan. Travis County has no integrated dual plans, so the two coverages are billed separately.
Yes. Novitas processes Original Medicare claims for Texas, and Qualigenix builds Austin Medicare claims to its edits and coverage policies. We also bill Medicare Advantage plans.
Qualigenix bills all payers: Texas Medicaid and its managed care plans, Medicare, Medicare Advantage, commercial HMOs and PPOs, and patient balances. You don't need a separate vendor for any payer.
Qualigenix charges a percentage of collections, so our fee rises only when your collections do. The exact percentage depends on your specialty and claim volume. Request a consultation for a quote.
No. What matters is a billing team that knows Travis County's Medicaid plans, Novitas and Texas commercial filing rules. Qualigenix bills Austin claims to all of them.