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Medical coding services
in San Antonio, TX
Qualigenix codes office visits, procedures and long-term services for San Antonio practices through our medical coding services for independent practices.
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How Qualigenix serves San Antonio practices
Qualigenix codes charts for independent practices across San Antonio and Bexar County, using the Texas rules on our page for medical coding services in Texas. A San Antonio coder needs more than CPT and ICD-10-CM. The same visit can go to a Bexar STAR plan, to Novitas for Medicare or to a commercial plan, and each one publishes its own coverage and payment policies. Qualigenix codes the chart once, checks it against the policy of the payer that will pay it, and sends a query to the provider when the note doesn't support the code. Coders stay on your specialty, so they learn your providers' documentation habits and catch the same gaps earlier each month.
What medical coding services does Qualigenix provide in San Antonio?
Qualigenix assigns CPC- and CCS-certified coders to San Antonio practices for documentation review, ICD-10-CM, CPT and HCPCS coding, modifier checks, provider queries and two-level QA. Each chart is coded to the rules of the payer that pays it:
a Bexar Medicaid plan, Novitas for Medicare or a commercial insurer.
Medical coding for Bexar County's Medicaid plans
Qualigenix codes Texas Medicaid claims to the Texas Medicaid Provider Procedures Manual first, then to the policies of the patient's managed care plan. A code that passes one Bexar plan's edits can still deny at another, so the plan on the member's card decides how the chart is coded.
STAR and CHIP plans in the Bexar Service Area
HHSC lists four STAR plans in Bexar as of January 2026: Aetna, Community First, Superior and Wellpoint. The same four run CHIP. Each plan posts its own clinical and payment policies, and they don't always agree on which services need prior authorization or which modifiers they accept. Qualigenix keeps a policy file for each plan, so a well-child visit for a Community First member is coded the way Community First pays it, and a Texas Health Steps checkup carries the codes the program expects.
STAR+PLUS, STAR Kids and STAR Health
STAR+PLUS in Bexar runs through Community First, Molina and United, and it combines medical care with long-term services and supports. STAR Kids runs through Superior and Community First, and Superior covers children in foster care through STAR Health statewide. Long-term services are billed with different codes and units than office visits. Qualigenix codes those lines to each program's rules and checks units against the authorization before the claim is sent.
Texas Medicaid coding manual
HHSC updates the Texas Medicaid Provider Procedures Manual through the year. Qualigenix reviews each update for the codes your specialty bills. Statewide edits are summarized in our guide to Texas Medicaid coding rules.
RESULTS ACROSS 275+ PRACTICES
Results San Antonio practices can expect
Qualigenix reports these coding and audit figures across all client practices, not San Antonio alone.
98.9%
Coding accuracy
98.9%
Post-audit coding accuracy
98.6%
Audit pass rate
Reduced to 2%
Coding-related denials
300,000+
Charts audited per quarter
Reduced to under 1%
Compliance risk
2M+
Charts coded to date
PROVEN TRACK RECORDHIPAA-Compliant Revenue Cycle
275+ ClinicsGETTING STARTED
How onboarding works
Qualigenix starts coding for a San Antonio practice in 6 days on average.
01
Kickoff
We sign a BAA and SLA and agree on scope: encounter types and code sets.
02
Coders and charts
We assign coders who work your specialty and set up chart intake from your EHR.
03
Playbook
We write a coding playbook with your payer rules and guideline choices.
04
Documentation review
Coders start reading charts and sending queries where notes fall short.
05
Coding and QA
Codes are assigned and pass two levels of review.
06
Go live
Coded charts export daily, and denial feedback goes back to your coders.
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WHY PRACTICES CHOOSE QUALIGENIX
Why Texas practices choose Qualigenix
Texas practices choose Qualigenix for four reasons.
CPC- and CCS-certified coders on your specialty
Your charts go to certified coders who code your specialty every day. That's how Qualigenix keeps over/undercoding under 2% across clients.
Works inside your EHR
Qualigenix codes inside your current system and supports 133 EMR/EHR platforms. Your providers keep the workflow they know.
Two levels of QA on every chart
Every coded chart gets a peer or auditor review and sampling by coder and specialty. Errors are caught before claims leave your office.
6-day average onboarding
Most practices start coding with us in about 6 days. Your coding playbook is written in the first week.
HAVE QUESTIONS?
Frequently Asked Questions
Frequently asked questions about our setup and support in San Antonio.
Qualigenix is one of several companies that code for San Antonio practices. We assign certified coders by specialty and code each chart to Texas Medicaid, Novitas or commercial payer rules. Coders stay on one specialty, and every chart gets two levels of QA. Call 786-259-0231 to talk to a coding specialist about your chart volume.
Yes. Qualigenix codes claims for the STAR, CHIP, STAR+PLUS and STAR Kids plans in the Bexar Service Area. We code to the Texas Medicaid Provider Procedures Manual first, then to the clinical and payment policies of the patient's plan. Each Bexar plan gets its own policy file, so a code that one plan accepts isn't assumed to pass at another.
Qualigenix checks each Medicare claim against the Novitas local coverage determination for that service. If the chart doesn't support medical necessity, we hold the claim and send the provider a query for the missing documentation. Once the note is complete, the claim goes out with the diagnosis that supports the service.
Yes. Qualigenix coders hold CPC and CCS certifications and are assigned to one specialty, so the same coders read your providers' notes every day. Every coded chart also goes through two levels of QA, and post-audit coding accuracy across clients is 98.9%.
Qualigenix codes ICD-10-CM, ICD-10-PCS, CPT and HCPCS Level II across office visits, procedures, long-term services and risk adjustment. We agree on encounter types and code sets with you at kickoff, and FY 2027 ICD-10-CM codes have been in use since October 1, 2026.
Qualigenix charges a percentage of collections, so pricing depends on your specialty, chart volume and scope. There's no separate charge for the two-level QA or provider queries. Ask a coding specialist for a quote.
No. What matters is that your coders know Texas Medicaid policy, the Bexar plan policies and the Novitas LCDs. Qualigenix codes for practices in 48 states and builds a policy file for each of your payers, from Community First to Novitas.