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Medical coding services
in Austin, TX
Qualigenix codes Austin charts to the rules each payer actually applies, from Travis County Medicaid plans to Novitas and commercial carriers.
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How Qualigenix serves Austin practices
The Qualigenix medical coding services team codes for independent practices in Austin and the surrounding Travis Medicaid service area, including Williamson and Hays counties. Coders are assigned by specialty and certified as CPC or CCS, and they code across all payers. Austin coding has three rule sets layered on each other: Texas Medicaid policy, the policies of each Travis County managed care plan and Medicare coverage rules from Novitas. Statewide Medicaid coding guidance sits on our medical coding services in Texas page. This page covers the Austin layer: which plans publish their own coding and payment policies here, and how Qualigenix codes Medicare and commercial charts for Austin practices.
What medical coding services does Qualigenix provide in Austin?
Qualigenix provides specialty coding, E/M coding, modifier and NCCI edit review, coding audits, charge capture and coding denial review for Austin practices.
Our CPC- and CCS-certified coders work inside your EHR and code to Texas Medicaid, Travis County plan, Novitas and commercial payer policies. Pricing is a percentage of collections.
Medical coding for Travis County's Medicaid plans
Texas Medicaid applies National Correct Coding Initiative edits, and each managed care plan adds its own payment policies on top. In Travis County that means coding to the rules of five different plans. Qualigenix checks the patient's plan before coding so the right policy set applies.
STAR and CHIP plan coding policies
Blue Cross and Blue Shield of Texas, Superior HealthPlan and Dell Children's Health Plan carry STAR and CHIP members in Travis County. Each publishes provider manuals and payment policies that can bundle codes, limit units or require specific modifiers beyond the base Medicaid rules. Children's checkups under Texas Health Steps carry their own documentation and coding requirements. Qualigenix coders keep a policy reference for each plan and code the chart to the plan on file for that date of service, so a correctly documented visit isn't denied over a plan-specific edit.
STAR+PLUS and STAR Kids coding and authorization rules
STAR+PLUS in Travis County runs through Superior and UnitedHealthcare Community Plan. STAR Kids runs through Blue Cross and Blue Shield of Texas and Superior. Both programs lean on service authorizations, and an authorization is tied to specific codes and units. If the coded service doesn't match the approved code or exceeds the approved units, the claim denies even when the care was medically necessary. Qualigenix coders compare each coded line to the authorization before release and flag mismatches to your staff the same day.
Texas Medicaid coding rules statewide
Coding guidance that applies across the state, including Texas Medicaid procedure manual rules, is covered on our Texas Medicaid coding rules page. Austin charts follow those rules first and then the plan's policies.
RESULTS ACROSS 275+ PRACTICES
Results Austin practices can expect
These are Qualigenix company-wide results, not Austin-only figures. Your results depend on your specialty, documentation habits and payer mix.
98.9%
Coding accuracy
98.6%
Compliance/audit pass rate
Under 2%
Over/undercoding rate
Reduced to 2%
Coding-related denials
99%
Documentation compliance rate
300,000+
Charts audited per quarter
Reduced to under 1%
Compliance risk
PROVEN TRACK RECORDHIPAA-Compliant Revenue Cycle
275+ ClinicsGETTING STARTED
How onboarding works
Qualigenix onboards an Austin coding client in 6 days on average.
01
Discovery call
we review your specialty, payer mix, coding volume and recent denials.
02
System access
our coders get access to your EHR. Qualigenix works in 133 EMR/EHR platforms.
03
Payer policy setup
we load the policies for your Travis County Medicaid plans, Novitas and your commercial payers.
04
Baseline review
we code a sample of recent charts to find documentation gaps before go-live.
05
Go-live
charts are coded daily, with feedback to providers and monthly accuracy reports.
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WHY PRACTICES CHOOSE QUALIGENIX
Why Austin practices choose Qualigenix
Texas practices choose Qualigenix for four reasons.
Coders assigned to your specialty
Your charts go to CPC- and CCS-certified coders who code your specialty every day. That focus keeps accuracy at 98.9% and the over/undercoding rate under 2%.
Works inside your EHR
Qualigenix codes inside the system you already use, across 133 EMR/EHR platforms. Your providers keep documenting the way they do now.
Coding feedback for providers
When a note doesn't support the code a provider expected, we tell them why and what to document next time. Fewer queries follow each month.
6-day average onboarding
Most practices go live in 6 days. We code a baseline sample first so you see your documentation gaps before the first claim goes out.
HAVE QUESTIONS?
Frequently Asked Questions
Frequently asked questions about our setup and support in Austin.
Qualigenix provides medical coding for independent practices in Austin and across Texas. Our certified coders code to Travis County Medicaid plans, Novitas and commercial payer policies. Talk to a coding specialist to discuss your specialty.
Yes. Qualigenix codes for all Travis County Medicaid plans, including Blue Cross and Blue Shield of Texas, Superior HealthPlan, Dell Children's Health Plan and UnitedHealthcare Community Plan. Each chart is coded to the policy of the plan on file.
Qualigenix checks each Medicare chart against the Novitas local coverage determinations that apply to the service. If the documented diagnosis doesn't support the procedure, we flag it before the claim goes out.
Yes. Qualigenix coders hold CPC or CCS certification and are assigned by specialty. They code across 38+ specialties.
Yes. Qualigenix runs coding and documentation audits with a 98.6% audit pass rate. Audits show where documentation falls short before a payer or state reviewer finds it.
Qualigenix charges a percentage of collections. The exact percentage depends on your specialty and chart volume. Request a consultation for a quote.
No. What matters is coders who know Travis County plan policies, Novitas coverage rules and your specialty. Qualigenix coders work inside your EHR wherever your practice is.