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Medical billing services
in San Antonio, TX
Qualigenix bills Bexar County's Medicaid plans, Medicare and every commercial payer for independent practices in San Antonio, through our medical billing services for independent practices.
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How Qualigenix serves San Antonio practices
Qualigenix runs billing for independent practices in San Antonio and the rest of Bexar County, under the Texas rules set out on our page for medical billing services in Texas. San Antonio sits in the Bexar Service Area, which the Texas Health and Human Services Commission (HHSC) draws around eight counties: Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina and Wilson. A family or pediatric practice here can see members of four STAR plans, three STAR+PLUS plans and two STAR Kids plans in one week, and each plan has its own payer ID, claim address and portal. Qualigenix builds every claim for the plan on the member's card that day and tracks it until it pays. We bill all payers, so Medicare and commercial claims stay with the same team.
What medical billing services does Qualigenix provide in San Antonio?
Qualigenix checks eligibility, reviews charges, scrubs and submits claims, posts payments, works denials and follows up on aged A/R for San Antonio practices. We bill all payers, from the STAR, STAR+PLUS and STAR Kids plans in the Bexar Service Area to Novitas for Medicare and every commercial insurer.
You pay a percentage of collections.
Medical billing for Bexar County's Medicaid plans
Qualigenix sends each San Antonio Medicaid claim to the managed care plan that covers the patient on the date of service. Most Texas Medicaid members are in managed care, so a plan, not the state, pays most of your Medicaid claims.
STAR and CHIP plans in the Bexar Service Area
HHSC's January 2026 service area map lists four STAR plans in Bexar: Aetna, Community First, Superior and Wellpoint. The same four run CHIP here. Qualigenix keeps a separate payer setup for each one, so a claim for a Community First member doesn't land at Superior. When a child moves from STAR to CHIP or switches plans mid-year, we update coverage before the next claim goes out and rebill any visit that went to the old plan.
STAR+PLUS, STAR Kids and STAR Health
Adults with disabilities and older adults on STAR+PLUS in Bexar are with Community First, Molina or United. Community First joined STAR+PLUS here on September 1, 2024, when HHSC changed the plan lineup. Children on STAR Kids are with Superior or Community First, and children in foster care are covered by Superior's statewide STAR Health plan. Qualigenix bills each program on its own terms, because benefits and authorization rules change by program even when the plan name stays the same.
Texas Medicaid filing rules
Texas Medicaid expects most claims within 95 days of each date of service. Qualigenix sets that date as the deadline on every Medicaid claim and fixes rejections early. Appeal windows and statewide edits are covered in how Qualigenix handles Texas Medicaid claims statewide.
RESULTS ACROSS 275+ PRACTICES
Results San Antonio practices can expect
Qualigenix reports these figures across all client practices, not San Antonio alone.
98%
Clean-claim rate on first submission
36 days
Average collection cycle
29-32%
Average cash-flow improvement
$50M+
A/R recovered for client practices
4.8%
Denial rate
79%
Denials overturned
PROVEN TRACK RECORDHIPAA-Compliant Revenue Cycle
275+ ClinicsGETTING STARTED
How onboarding works
Qualigenix brings a San Antonio practice live in 6 days on average, and you keep your current software.
01
Kickoff and access
We sign a BAA and log in to your EHR and clearinghouse.
02
Payer check
We confirm your enrollment with each Bexar plan, Novitas and your commercial payers, then set up the accounts.
03
Coders and rules
We assign specialty coders and load scrub rules for each payer.
04
Routing
We set up EDI, ERA and EFT routing and send a test transaction.
04
Validation
A first batch runs through a pre-claim check before release.
05
Go live
New claims go out under Qualigenix while your older A/R is worked in parallel.
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WHY PRACTICES CHOOSE QUALIGENIX
Why San Antonio practices choose Qualigenix
Texas practices pick Qualigenix for four reasons.
Specialty-certified coders and dedicated billers
Your practice gets a named billing team and coders who work your specialty every day. Across clients, Qualigenix reports 98.9% coding accuracy, which keeps coding errors off your denial list.
Works inside your existing EHR
Qualigenix works in 133 EMR/EHR platforms. Your front desk keeps the screens it knows, and you don't buy or learn new software to start.
Monthly reporting with every metric defined
Each month you get collections, denials and A/R by payer, with a plain definition next to every number. You can compare each Bexar plan with Novitas and your commercial payers.
6-day average onboarding
Most practices go live in about 6 days. We work your older A/R in parallel, so cash from past visits keeps coming in during the switch.
HAVE QUESTIONS?
Frequently Asked Questions
Frequently asked questions about our setup and support in San Antonio.
Qualigenix is one of several companies that bill for San Antonio practices. We bill all payers, including the Bexar County Medicaid plans, Novitas for Medicare and commercial insurers, for independent practices in 38+ specialties. Call 786-259-0231 to talk to a billing specialist about your payer mix.
Yes. Qualigenix bills the STAR, CHIP, STAR+PLUS and STAR Kids plans in the Bexar Service Area, including Aetna, Community First, Superior, Wellpoint, Molina and United. Each claim goes to the plan on the member's card for that date of service, and we rebill quickly when a patient's plan changes.
Texas Medicaid expects most claims within 95 days of each date of service. Qualigenix sets that date as the deadline on every Medicaid claim, works rejections the day they come back and tracks commercial filing limits the same way.
Novitas Solutions processes Original Medicare claims for Texas as the Jurisdiction H contractor. Qualigenix builds Medicare claims to Novitas edits and coverage policies, posts each remittance and appeals Novitas denials with corrected documentation.
Qualigenix charges a percentage of collections, so our fee depends on what we collect for you. Ask a billing specialist for a quote based on your specialty, payer mix and claim volume.
Qualigenix brings most practices live in about 6 days. We keep your current EHR, test claim routing before go-live and work your older A/R in parallel, so collections don't stop during the switch.
No. What matters is that your billing team knows Texas Medicaid rules, the Bexar plans and Novitas edits. Qualigenix bills for practices in 48 states and sets up each Bexar plan before your first claim goes out.