Top Challenges that Affect The Performance of Medical Practices in Texas
Texas practices have some of the highest denial rates due to payer-specific criteria, prior authorization rules, and TMHP documentation requirements.
Do you know that Texas requires providers to submit claims within 95 days of service and bill patients no later than the first day of the 11th month after service? Missing these deadlines means forfeiting your right to payment entirely.
Under the Texas Prompt Pay Act (HB 610 & SB 418), electronic claims must be paid within 30 days; paper claims within 45 days or payers face penalties up to $200,000 plus 18% annual interest.
Don’t be one of them!
Dastify Solutions keeps your medical practice fully compliant and profitable.
Electronic claims must be paid within 30 days; paper claims within 45 days. Penalties for late payment range from 50% to 100% of the difference between billed and contracted rates, plus 18% annual interest for claims paid 91+ days late.
Claims must be received within 95 days from the date of service. Appeals must be filed within 120 days of the R&S Report disposition date.
Providers must bill patients no later than the first day of the 11th month after service. Failure to comply means forfeiting the right to collect from patients.
Texas Medicaid operates through MCOs including Superior HealthPlan, Amerigroup Texas, Molina Healthcare of Texas, UnitedHealthcare Community Plan, and Texas Children’s Health Plan.
We understand that local expertise matters in medical billing. At Dastify Solutions, we bring Texas-focused solutions to practices of all sizes, ensuring accuracy, compliance, and faster reimbursements.
Our professional medical billing in Texas has helped countless medical specialties achieve their goals, such as family medicine in Houston and orthopedics in Dallas. We are ready to do it for you!
Automated denial prediction using CARC/RARC patterns TMHP-compliant claim submission workflows
Medical Billing Solution Built Exclusively For Practices in Texas
Our billing company in Texas completely understands that running a medical facility is no easy task. We manage complex payer nuances to keep up with evolving compliance regulations and ever-evolving reimbursement models. These constant changes cause medical practices across Texas to face several revenue challenges, making it difficult to maintain financial stability.
But you don’t have to worry when Dastify Solutions is by your side because our HIPAA-Compliant Billing Texas will save you from all compliance and regulatory penalties. We conduct continuous in-house training sessions to help our medical coding experts stay up to date on changing state laws & policies. That’s why we claim never to miss a beat for medical specialties.
We provide the best medical billing solutions in Texas under industry standards, including:
Stay Protected From Costly Legal Penalties & HIPAA Violations
By 2024, over 180 million patient records in Texas were exposed due to weak data protection and HIPAA violations.
Your patients deserve better protection of their data.
With us, you get complete peace of mind with fully HIPAA-compliant medical billing services across Texas. We safeguard every piece of Protected Health Information (PHI) with industry-grade security and proactive compliance systems.
AES-256 Encryption
MFA for Secure Access
ONC-certified EHR Interoperability
IDS/IPS Threat Monitoring
Secure HL7/FHIR Data Exchange
Compliance with HITECH, CMS, and TMHP Security Guidelines
Protect your Billing Today!
Choosing the right medical billing partner is as essential as a heartbeat. Your practice revenue flow, reputation, patient satisfaction, and claim success rate are all directly connected to your Texas medical billing company. It’s like a make-or-break for your medical facility. That’s why we are the first choice for providers in Texas. Because we promise up to a 99% reduction in billing errors. We provide results that truly matter for medical physicians in Texas complete revenue cycle management.
Need tailored or stand-alone medical billing services in Texas? We have you covered!
Integrate effortlessly with leading EHR platforms like eClinicalWorks, Athena Health, and NextGen without downtime or data loss.
Here are some major roadblocks:
We set the benchmark for Outsourced Medical Billing in Texas, delivering precision, speed, and specialty-focused expertise. Our dedication to excellence and meticulous attention to every claim make us the go-to billing partner for practices nationwide.
We measure our success by yours; that’s why we focus on keeping your numbers higher. And for that, our professional medical billing coders in Texas make a constant effort.
Dastify Solutions never disappoints you when it comes to:
Texas Medicaid rules can be tough, but not when you have the right partner.
TMHP Claim Submission Rules:
We master every TMHP requirement so your claims move smoothly and get paid faster.
Texas Prior Authorization Policies:
Our experts stay ahead of policy changes to prevent costly denials.
MCO Billing for Medicaid & CHIP:
From complex Managed Care Organization rules to documentation accuracy, our professional handles everything without any hassle.
Telehealth & HHSC Reimbursements:
We keep your virtual and remote monitoring claims compliant with the latest HHSC updates.
Stay compliant, and profitable with us. We simplify the process, eliminate errors, and help your practice get every dollar it deserves.
Specialty-Focused Billing Expertise Across Texas.
Our Texas Medical Billing Company understands the unique needs of rural and community health providers across West Texas, Austin, San Antonio, and beyond.
We track PA requirements across STAR, STAR+PLUS, STAR Health, STAR Kids, and CHIP programs.
Under the Texas Prompt Pay Act, payers who fail to pay clean claims timely face significant penalties:
We handle the entire PA process including submitting requests with complete clinical documentation, tracking status and expiration dates, appealing denials, and maintaining compliance with HHSC’s PA timelines (72-hour urgent, 3-day expedited, 14-day standard).
This Texas medical billing Page was prepared by Dastify Solutions’ compliance and operations team, led by CPC® Director of Medical Coding Stephanie Jason. Our team includes AAPC-certified medical coders with specific expertise in Texas payer regulations, TMHP submission requirements, and Texas Insurance Code compliance.
Last Updated: January 2026
Have questions about Texas medical billing regulations? Contact our Austin office for a free consultation.
