Billing Automation – integrated with clearinghouse edits & payer rules
Medical Billing Services for Texas Healthcare Practices
Reduce denials, recover lost revenue, and stay compliant. Austin-based Dastify Solutions delivers expert Texas medical billing with AAPC-trained billers and deep payer knowledge across Medicaid, Medicare, and major commercial insurers.
AHIMA QualifiedCMRS SpecialistsRHIA/RHIT CredentialedCMS & Federal ComplianceTexas Insurance Code §1301 & §843 Compliant28 TAC Chapter 21, Subchapter T Knowledge
Top Challenges that Affect The Performance of Medical Practices in Texas
Denials, missing documentation and delayed follow-up can leave insurance balances unresolved. We review the practice’s payer mix and A/R inventory to identify next actions and establish a reporting baseline.
Claim denial and rejection rates can vary by payer, claim type, and practice.
19% of in-network claims were denied, according to KFF's analysis of Marketplace plan data
Front-desk and administrative tasks can consume significant staff time and resources in medical practices.
Real-Time Tracking – Monitor every claim and payment in real time.
Texas Law Compliance – Stay transparent under the Surprise Billing Law.
Texas Payer and Filing Requirements
Texas billing requirements depend on the payer, plan, claim type and service. During workflow setup, we identify the applicable submission, appeal and payment rules for the practice’s payer mix. Texas Department of Insurance guidance and TMHP provider resources should be checked alongside the payer’s current requirements.
Texas MCO (Managed Care Organization) Billing
Texas Medicaid operates through MCOs including Superior HealthPlan, Amerigroup Texas, Molina Healthcare of Texas, UnitedHealthcare Community Plan, and Texas Children’s Health Plan.
Serving Providers Across Texas
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.
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 We support documented billing controls and compliance processes; compliance remains a shared responsibility based on the practice’s obligations, payer requirements, and contracted scope of services. 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:
Texas Prompt Payment Law
No Surprise Billing Law
Timely Filing Requirements
Clean Claims Requirements
HIPAA Compliance & PHI Security
Medical Necessity & Accurate Coding
Patient Transparency & Good Faith Estimates
Medical Records Retention & Disclosure
Medicare & Medicaid-Specific Billing Rules
HHSC (Health and Human Services Commission) Rules
Custom reports for practice insights
Stay Protected From Costly Legal Penalties & HIPAA Violations
Healthcare data breaches exposed millions of individuals across the United States in 2024, highlighting the importance of protecting patient information.
Your patients deserve better protection of their data.
We support documented billing controls and compliance processes; compliance remains a shared responsibility based on the practice’s obligations, payer requirements, and contracted scope of services. We safeguard every piece of Protected Health Information (PHI) with industry-grade security and proactive compliance systems.
AES-256 Encryption
MFA for Secure Access
We work within client-approved EHR systems
Support available security monitoring controls
Support available HL7/FHIR exchange workflows
Compliance with CMS and TMHP Security Guidelines
Protect your Billing Today!
Book 1-on-1 DemoMedical billing and RCM support for Texas practices
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 best choice for providers in Texas. We use layered claim checks and human review to help reduce preventable billing errors; results depend on documentation quality and payer requirements. 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!
End-to-End Revenue Cycle Management (RCM)→ Texas-specific payer rules, TMHP, Medicaid MCOs
Insurance Eligibility Verification → Real-time EDI (270/271) checks
Prior-Authorization Services → Texas payer guidelines, medical necessity criteria
Medical Billing & Coding → CPT/ICD-10, HCPCS, NCCI edits
Claim Submission & Scrubbing Services → EDI 837 + clearinghouse edits
Payment Posting → ERA 835 processing
AR Recovery & Denial Management → Texas denial trends such as CO-16, CO-50, PR-49
Credentialing Services → Medicare, Medicaid, BCBS TX, Superior HealthPlan, Amerigroup, MCO enrollment
Want Seamless EHR Integration without disrupting your workflow?
Integrate effortlessly with leading EHR platforms like eClinicalWorks, Athena Health, and NextGen without downtime or data loss.
Here are some major roadblocks:
HL7 / FHIR-ready workflow
PMS optimization for Texas Medicaid & TMHP
Real-time demographic verification to reduce rejections
Why Physicians in TX Trust Dastify Solutions?
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 payer-specific regulations
TMHP documentation accuracy
Managed Care Organization (MCO) requirements
Local Medicare coverage policies
Professional Billers
Serving in multiple States
BBB-Accredited
Covering 50+ Specialties
Don’t Let Texas Medicaid Nuances Cost You Revenue
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.
Ready to Improve Your Practice?
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 Work With all Major Texas Medicaid MCOs:
Superior HealthPlan
Amerigroup Texas
Molina Healthcare of Texas
UnitedHealthcare Community Plan
Texas Children's Health Plan
We track PA requirements across STAR, STAR+PLUS, STAR Health, STAR Kids, and CHIP programs.
FAQs.
What is the Texas 95-day claim filing deadline, and how do you ensure compliance?
Under TMHP rules, claims must be received within 95 days from the date of service (or date of discharge for inpatient stays). Missing this deadline means Texas Medicaid will not pay the claim period. Dastify Solutions uses automated tracking to flag claims approaching the 60-day mark, ensuring submission with ample buffer time.
Do you handle Texas Medicaid MCO billing?
Yes. Texas operates Medicaid primarily through managed care organizations (MCOs). We handle billing for all major Texas Medicaid MCOs including Superior HealthPlan, Amerigroup Texas, Molina Healthcare of Texas, UnitedHealthcare Community Plan, and Texas Children’s Health Plan.
What happens if a Texas payer doesn't pay my claim on time?
Under the Texas Prompt Pay Act, payers who fail to pay clean claims timely face significant penalties:
- Within 45 days late: Lesser of $100,000 or 50% of difference
- 46-90 days late: Lesser of $200,000 or 100% of difference
- 91+ days late: $200,000 or 100% PLUS 18% annual interest
How do you handle prior authorizations for Texas payers?
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).