Loading...
RCM services
in Austin, TX
Qualigenix runs the full revenue cycle for Austin practices, from eligibility checks before the visit to the last patient balance. Talk to a revenue cycle specialist at 786-259-0231 or request a consultation. Qualigenix is HIPAA compliant.
Request a Callback
Speak with our RCM specialists today.
How Qualigenix serves Austin practices
The Qualigenix revenue cycle management services team runs one connected process for independent practices in Austin and the nearby Travis Medicaid service area counties, including Williamson and Hays. The same team that checks eligibility on Monday follows the claim to payment, so nothing falls between vendors. Austin practices work with three payer groups: Texas Medicaid managed care plans, Medicare and state-regulated commercial HMOs and PPOs. Each sets its own rules for eligibility, authorization, filing and payment timing. Statewide rules are on our RCM services in Texas page. This page covers the Austin side: which plans patients carry here and how Qualigenix moves a visit from check-in to cash for each one.
What revenue cycle management services does Qualigenix provide in Austin?
Qualigenix provides eligibility and benefits verification, prior authorization, charge entry and coding, claim submission, payment posting, denial management, A/R follow-up, patient billing and reporting for Austin practices.
One team handles all payers, including Travis County Medicaid plans, Medicare through Novitas and commercial plans. Pricing is a percentage of collections.
Revenue cycle work for Travis County's Medicaid plans
Most Texas Medicaid patients are in managed care, and in Travis County the plan decides who verifies eligibility, who approves authorizations and where the claim goes. Qualigenix sets up each step by plan before your first visit with us.
Eligibility and authorization for STAR and CHIP patients
Blue Cross and Blue Shield of Texas, Superior HealthPlan and Dell Children's Health Plan carry STAR and CHIP members in Travis County. Medicaid eligibility can change month to month, and patients can switch plans. Qualigenix checks eligibility and plan assignment before each scheduled visit through TMHP and the plan's portal, then requests any authorization the plan requires. If the plan changed, we update the account before the visit so the claim, the authorization and the payment all point to the same payer.
STAR+PLUS and STAR Kids from authorization to payment
STAR+PLUS runs through Superior and UnitedHealthcare Community Plan in Travis County, and STAR Kids through Blue Cross and Blue Shield of Texas and Superior. Both rely on service authorizations tied to codes and units, and many STAR+PLUS members also have Medicare. Qualigenix tracks each authorization's units and end date, bills Medicare first for dual-eligible patients, posts that payment, then sends the balance to the STAR+PLUS plan. Authorizations close to their end date are flagged for renewal before services run past them.
Texas Medicaid revenue cycle rules statewide
Statewide rules, including the 95-day Medicaid filing deadline from each date of service, are covered on our Texas Medicaid RCM rules page. Austin follows them, with the Travis County plan list layered on top.
RESULTS ACROSS 275+ PRACTICES
Results Austin practices can expect
These are Qualigenix company-wide results across 275+ practices onboarded, not Austin-only figures. Your results 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
Reduced to 38%
A/R over 90 days
79%
Denials overturned
29-32%
Cash-flow improvement
$923M+
Revenue recovered
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 payer mix, A/R aging and front-desk workflow.
02
System access
we connect to your EHR, practice management system and clearinghouse. Qualigenix works in 133 EMR/EHR platforms.
03
Payer setup
we confirm enrollment and portal access for your Travis County plans, Novitas and commercial payers.
04
A/R triage
open claims are sorted by filing deadline and dollar value, and the oldest at-risk claims are worked first.
05
Go-live
eligibility checks start on your next schedule, and monthly reporting begins.
Loading Integrations...
WHY PRACTICES CHOOSE QUALIGENIX
Why Austin practices choose Qualigenix
Texas practices hand Qualigenix their revenue cycle for four reasons.
One team from eligibility to payment
The team that checks eligibility follows the claim to payment. Nothing gets lost in a handoff between a front-end vendor and a billing vendor.
Works with any EHR
Qualigenix works inside your current system, across 133 EMR/EHR platforms. No migration and no new software for your staff.
Monthly reporting by payer
Every month you see collections, denials, days in A/R and late payments by payer, including each Travis County Medicaid plan.
6-day average onboarding
Most practices go live in 6 days. We triage your open A/R first, so the switch doesn't cost you claims near their deadline.
HAVE QUESTIONS?
Frequently Asked Questions
Frequently asked questions about our setup and support in Austin.
Qualigenix provides revenue cycle management for independent practices in Austin and across Texas, covering all payers. One team handles eligibility, authorization, claims, payments and A/R. Talk to a revenue cycle specialist to review your current cycle.
It includes eligibility and benefits verification, prior authorization, charge entry and coding, claim submission, payment posting, denial management, A/R follow-up, patient billing and monthly reporting. Every payer is covered.
Yes. Qualigenix submits and tracks prior authorization requests for Travis County Medicaid plans, Medicare Advantage plans and commercial payers. We follow each request until the payer decides.
Qualigenix confirms the patient's Travis County plan before the visit, then bills that plan. For dual-eligible patients, we bill Medicare first and send the remaining balance to the STAR+PLUS plan.
Qualigenix cuts A/R by checking eligibility before the visit, filing clean claims fast and working every open claim by age and payer. Across clients, days in A/R dropped from 54 to 36.
Qualigenix charges a percentage of collections, so our fee grows only when your collections do. The percentage depends on your specialty and volume. Request a consultation for a quote.
No. What matters is a team that knows Travis County's Medicaid plans, Novitas and Texas commercial payment rules. Qualigenix runs the Austin revenue cycle inside your existing systems.