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Medical billing services
in Houston, TX
Qualigenix bills Texas Medicaid, Medicare and commercial payers for independent practices, and files every claim inside the payer's deadline.
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How Qualigenix serves Texas practices
Qualigenix bills every payer a Houston practice sees, from Texas Medicaid managed care plans to Medicare and commercial insurers. Statewide rules, like the Texas Medicaid filing window and commercial prompt-pay timelines, are covered on our page for medical billing services in Texas. This page covers what's different about Houston. Harris County patients can be enrolled in any of five STAR plans, three STAR+PLUS plans or three STAR Kids plans. Dual-eligible patients may be in a plan that pairs Medicare with STAR+PLUS under one card. Each plan has its own claims address, payer ID and authorization rules, and a claim sent to the wrong plan doesn't get paid. Qualigenix confirms the plan first, then bills it.
What medical billing services does Qualigenix provide in Houston?
Qualigenix medical billing services cover the full billing cycle for Houston practices: eligibility checks, coding, charge entry, claim submission, denial appeals, A/R follow-up and credentialing. We bill all payers, including the Medicaid managed care plans in the Harris service area, Novitas for Medicare, and commercial carriers. Pricing is a percentage of collections.
We bill all payers, including Texas Medicaid and its managed care plans, Medicare through Novitas Solutions, and commercial plans. Claims are tracked against each payer's filing window, so none age out.
Texas medical billing problems we solve
Texas practices lose money in four places: Medicaid's short filing window, commercial claims that stall without follow-up, Medicare claims that miss coverage rules, and patient bills that break the state's balance-billing limits. Qualigenix built a workflow for each one.
STAR and CHIP claims across five Harris plans
The Texas Health and Human Services Commission's January 2026 plan table lists five STAR plans in the Harris service area: Community Health Choice, Molina, Texas Children's, United and Wellpoint. The same five plans carry CHIP. Most Houston Medicaid patients, including children and pregnant women, are in one of them. Qualigenix runs eligibility checks before each visit so the plan on the claim matches the plan on file. Patients can switch plans, and a claim billed to last month's plan comes back denied. When that happens, our team corrects the payer, resubmits the claim and tracks it to payment. Every STAR and CHIP claim is logged by date of service, so nothing ages past the filing window while it waits in a queue.
STAR+PLUS, STAR Kids and STAR Health claims
Qualigenix also bills the smaller Medicaid programs, where an authorization often decides whether a claim pays. In the Harris service area, STAR+PLUS covers adults 65 and older and adults with disabilities through Community Health Choice, Molina and United. STAR Kids covers children and young adults 20 and younger with disabilities through Texas Children's, United and Wellpoint. STAR Health, for children in the care of the Texas Department of Family and Protective Services, runs statewide through Superior. Each of these programs has its own member ID format, so Qualigenix matches the ID to the program before billing. Many services for these patients need approval before the visit, so Qualigenix ties prior authorization tracking to each claim. An authorization number that's missing, expired or issued by a different plan gets caught before the claim goes out, not after it's denied.
Texas Medicaid rules that apply statewide
Texas Medicaid expects most claims within 95 days of the date of service. Qualigenix sets that deadline on every Medicaid claim the day the charge is entered and works it well before the window closes. For the full set of statewide rules, see how Qualigenix handles Texas Medicaid claims statewide.
RESULTS ACROSS 275+ PRACTICES
Results Houston practices can expect
Qualigenix's numbers below are company-wide results across 275+ practices in 48 states, not Houston-only figures. They show what our process produces when a practice hands us its full billing.
98.2% on first submission
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 recovered
PROVEN TRACK RECORDHIPAA-Compliant Revenue Cycle
275+ ClinicsGETTING STARTED
How onboarding works
Qualigenix onboards a Houston practice in 6 days on average. The process has five steps.
01
Discovery call
We learn your specialty, payer mix, claim volume and current A/R.
02
System access
Our team works inside your existing EHR and practice management system. Qualigenix works with 133 EMR/EHR platforms.
03
Payer setup
We confirm your enrollment with each Harris County Medicaid plan, Novitas and your commercial payers, and flag any gaps.
04
Claims go live
New claims start flowing through our team, and open A/R is sorted by age and payer for follow-up.
05
Monthly reporting
Each month you get a report showing collections, denials and A/R by payer.
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WHY PRACTICES CHOOSE QUALIGENIX
Why Houston practices choose Qualigenix
Texas practices pick Qualigenix for four reasons.
Specialty-assigned coders
Your claims go to coders who work in your specialty every day. That's how Qualigenix holds 98.9% coding accuracy across 38+ specialties.
Works with any EHR
Qualigenix works inside the system you already use, across 133 EMR/EHR platforms. You don't change software to change billing companies.
Transparent monthly reporting
Each month you see collections, denials and A/R by payer, including each Harris County Medicaid plan. You'll know which payer owes you and why.
6-day average onboarding
Most practices go live in about a week. Your claims keep moving while we take over.
HAVE QUESTIONS?
Medical Billing in Houston, answered
Frequently asked questions about our setup and support in Houston.
Qualigenix is a medical billing company that serves Houston practices across 38+ specialties and bills all payers, including the Medicaid plans in the Harris service area. Houston also has smaller billing firms. Compare clean claim rate, denial overturn rate and reporting before you choose.
Yes. Qualigenix bills the STAR, STAR+PLUS and STAR Kids plans in the Harris service area, plus CHIP and STAR Health. We check the patient's plan on the date of service before each claim goes out. Talk to a billing specialist about your plan mix.
In Harris County, Molina and UnitedHealthcare offer Integrated D-SNPs that pair Medicare with the same company's STAR+PLUS plan. Qualigenix bills the claim to the plan on the patient's card and confirms your Texas Medicaid enrollment is active so cost-sharing pays. Talk to a billing specialist if dual-eligible claims are stuck.
Novitas Solutions processes Original Medicare Part A and Part B claims for Texas as the Jurisdiction H contractor. Qualigenix codes Houston Medicare claims against Novitas's coverage policies before submission. Medicare Advantage and Integrated D-SNP claims go to the patient's plan instead, so we confirm coverage type at every visit.
Qualigenix logs every Medicaid claim by date of service and sets its filing deadline the day the charge is entered. Our average submission turnaround is under 24 hours, and rejected claims are corrected and resent before the window closes. Ask a billing specialist how we track aging claims.
Qualigenix charges a percentage of collections, so our fee grows only when your collections do. The exact percentage depends on your specialty, claim volume and the services you need. Request a consultation to get a quote for your practice.
No. What matters is that your billing team knows Harris County's Medicaid plans, Novitas's Medicare rules and Texas filing deadlines. Qualigenix builds those rules into every Houston claim, and you see the results in a monthly report. Talk to a billing specialist to see how it works.