Medical Billing Services for Texas Practices
Texas practices bill some of the most demanding payers in the country. Texas Medicaid has a short filing window, Medicare claims go through a regional contractor, and commercial plans follow state prompt-pay rules that you can only enforce if you track them. 24Front Billing is an online medical billing and revenue cycle management (RCM) company that works with Texas practices remotely, statewide, from 2.5% of collections.
What we handle for Texas practices
Our services are the same ones listed on our services page, applied to Texas payers:
- Medical billing. Charge review, claim preparation and submission across all payers, plus payment posting.
- Revenue cycle management. Eligibility through reimbursement, with live monthly performance reporting.
- Denial management. We find out why claims were denied, correct them and appeal within the payer's deadline.
- Credentialing and payer enrollment. Help with provider credentialing and payer enrollment. See our credentialing page for details.
- A/R recovery. Working old, unpaid balances before they age past filing and appeal limits.
- Billing audits. A review of your current billing to find lost revenue and recurring errors.
Because we work online, you don't need a local billing office. We work in your practice management system or clearinghouse and report to you every month.
Texas Medicaid billing: TMHP and the 95-day rule
Texas Medicaid fee-for-service claims are processed by the Texas Medicaid & Healthcare Partnership (TMHP). Its rules leave little room for slow billing:
- Claims must be received by TMHP within 95 days of each date of service, unless an exception applies. Texas Medicaid does not pay late claims.
- Appeals must be received within 120 days of the disposition date on the Remittance and Status (R&S) Report.
- If the 95th or 120th day falls on a weekend or a listed holiday, the deadline moves to the next business day. TMHP publishes a filing deadline calendar every year.
- Paper claims need an NPI and taxonomy code for the billing and performing provider, or they are denied.
Source: TMHP, Texas Medicaid Provider Procedures Manual, Section 6: Claims Filing (October 2026): Source, and the TMHP 2026 Filing Deadline Calendar: Source
A 95-day window means claims have to go out, and rejections have to be fixed, within days, not weeks. We work with the payer rules in your state, and we track claims against their filing deadlines so they don't age out.
Medicare in Texas: Novitas Solutions, Jurisdiction H
Medicare Part A and Part B fee-for-service claims in Texas are processed by Novitas Solutions, Inc., the Medicare Administrative Contractor (MAC) for A/B Jurisdiction H (JH). Novitas's local coverage determinations (LCDs), enrollment and claim edits apply to Texas providers.
Source: CMS, "Who are the MACs: A/B MAC Jurisdiction H (JH)": Source, and CMS Local Coverage Determinations: Source
Federal rules generally require Medicare claims to be filed within one calendar year of the date of service. Source: 42 CFR 424.44: Source
We check claims against Novitas JH edits and coverage policies before submission, and we manage Medicare enrollment through credentialing.
Texas prompt-pay rules for commercial claims
Texas has strict prompt-pay rules for preferred provider (PPO) and HMO plans regulated by the Texas Department of Insurance (TDI). For a clean claim, the plan must decide and pay, deny or audit within:
- 30 calendar days for claims submitted electronically
- 45 calendar days for paper claims
Source: Texas Insurance Code §1301.103: Source, and TDI, "Prompt Pay of Clean Claims": Source
If a PPO insurer pays a payable clean claim late, the law sets penalties: the lesser of 50% of the difference between billed charges and the contracted rate or $100,000 for the first 45 days late, rising to the lesser of 100% or $200,000 from day 46 to 90, plus 18% annual interest from day 91. Source: Texas Insurance Code §1301.137: Source
These protections only help if your claims are clean and someone tracks the clock. We submit electronically, so the 30-day clock applies, and we flag late payments so you can pursue what you are owed. Self-funded employer plans regulated under federal law may not follow Texas prompt-pay rules, and we track those separately.
Who we work with in Texas
We support physician practices and dental offices across Texas, including primary care, family and internal medicine, behavioral health, urgent care, pediatrics, OB-GYN, cardiology, neurology, pain management, podiatry, urology, labs and DME suppliers, plus general and specialty dentistry. See our specialties page for the full list.
Pricing
Medical billing for Texas practices starts at 2.5% of collections. Your final rate depends on specialty, claim volume and the services you choose. Use the Plan Builder or request pricing for a quote.
Please don't send patient information through our forms. If you have questions about data handling, contact us and we'll walk you through our process.
Frequently asked questions
For most claims, TMHP must receive the claim within 95 days of each date of service. Appeals must be received within 120 days of the disposition date on the R&S Report. Deadlines that fall on a weekend or listed holiday move to the next business day.
Novitas Solutions, Inc. is the Medicare Administrative Contractor for A/B Jurisdiction H, which includes Texas.
Under Texas prompt-pay rules for TDI-regulated PPO and HMO plans, clean claims must be paid, denied or audited within 30 days if submitted electronically or 45 days on paper.
No. 24Front Billing works online and supports practices across Texas and the rest of the US remotely, inside your existing systems.
Pricing starts at 2.5% of collections. Your rate depends on specialty, volume and services. Request pricing for a custom quote.
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