Clean claims, faster payments and fewer denials for practices from Katy to Clear Lake. Our Texas billing team works inside your current systems and knows the payers your patients use.
Supported by our team in Austin, Texas
Prime Medical Revenue provides medical billing services Houston practices use to get paid on time, from single-provider clinics in Katy to specialty groups near the Texas Medical Center. We verify coverage, file clean claims, post every payment and work each denial until it is resolved.
Our office is in Austin, about 165 miles west on US-290. We do not need to sit in your building to run your billing well. Your team gets one point of contact, regular reports and answers within one business day.
We already bill Texas Medicare, Texas Medicaid managed care and the large commercial plans that cover most patients in Harris and Fort Bend counties. That means less time teaching your biller the rules and more time collecting what you earned.
10M
Patient encounters a year at the Texas Medical Center
95
Days Texas providers have to file a claim
30
Days a Texas payer has to pay a clean e-claim
49+
Medical specialties we bill for
As a medical billing company Houston practices can reach within one business day, we offer each service on its own or as part of the full revenue cycle. These are the medical billing services Houston TX clinics ask for most.
From Katy to the Texas Medical Center, one team runs the full cycle, from the eligibility check to the final payment. Our revenue cycle management works inside your current EMR and clearinghouse.
Many patients in Harris County carry STAR, STAR+PLUS, STAR Kids or CHIP plans, each with its own authorization list. Our eligibility and benefits verification confirms coverage and prior authorization before the visit.
Cardiology, orthopedics and imaging claims carry more modifiers and edits. Our electronic claim submission scrubs each claim against payer rules, so high-value specialty claims are paid the first time.
Adding a provider in Sugar Land or The Woodlands? Our physician credentialing services handle CAQH upkeep, payer applications and follow-up until each Medicare, Medicaid and commercial enrollment is approved.
Nearly 15% of claims to private payers are denied at first, according to Premier Inc. Our denial management team files appeals within each payer’s limit and fixes the root cause so it does not repeat.
Every ERA, EOB and check is posted to the right charge. Our insurance payment posting catches underpayments, hidden denials and credit balances, so your office knows exactly what each payer paid.
Want to see where revenue is slipping before you change anything? Our medical billing audit services review coding, charge capture, claim quality and A/R, then hand you a clear fix plan.
Specialty-heavy claims from the Medical Center area need codes that match the note. Our outsourced medical coding services assign CPT, ICD-10-CM and HCPCS codes, E/M levels and modifiers your documentation supports.
When your only biller is out, claims stop. Our medical practice billing services give smaller clinics in Pearland, Spring or Baytown a team that keeps work moving through sick days, staff changes and hurricane season.
Houston is home to the Texas Medical Center, the largest medical complex in the world with about 10 million patient encounters a year. That size brings a dense payer mix and very specific billing rules.
Medicare Part A and B claims in Texas are processed by Novitas Solutions, the Jurisdiction H contractor. Its local coverage rules and edits shape how many local claims should be coded.
Many patients in the region are covered by STAR, STAR+PLUS, STAR Kids or CHIP plans. Each managed care plan has its own prior authorization list and filing steps on top of TMHP rules.
Blue Cross Blue Shield of Texas, UnitedHealthcare, Aetna, Cigna and Humana all run different edits and appeal windows. One missed rule can hold a claim for weeks.
Cardiology, orthopedics, oncology and imaging claims carry more modifiers and authorizations. Small coding errors on high-value claims cost the most.
When your only biller is out, claims stop. A billing team keeps work moving when someone is sick, on leave or has left.
Storms along the Gulf Coast can close offices for days. A remote billing team keeps filing and following up while your office recovers.
Denials are not rare. Hospitals surveyed by Premier Inc. reported that nearly 15% of claims sent to private payers were denied at first. More than half of those denials, 54.3%, were later overturned and paid.
That means a lot of work goes into money that should have been paid the first time. The same survey put the average cost of fighting one denial at $43.84 in staff time.
On plans sold through HealthCare.gov, insurers denied 19% of in-network claims in 2024, according to KFF. Fewer than 1% of those denials were ever appealed. Unworked denials are simply lost revenue.
Sources: Premier Inc. claims denial survey and KFF, Claims Denials and Appeals in ACA Marketplace Plans in 2024. Learn more about our denial management services.
There are many billing companies between Katy and Clear Lake, and most offer the same list of services. The difference is how the work gets done. Ours is a Texas team that puts denials first, reports what it did and adapts to your software.
Tied to one biller’s habits
Works inside your EMR, PM system and clearinghouse
Stops when the biller is away
A team keeps claims moving
Worked when time allows
Worked first, traced to the root cause
Learned claim by claim
Novitas, TMHP, STAR plans and BCBSTX already known
Often informal
Weekly or monthly reports on filed, paid and open claims
You can start with one service, such as denial management or credentialing, and keep the rest in-house. Many practices begin with a billing audit to see where revenue is slipping first.
Billing keeps revenue flowing. These services help more patients from Sugar Land to Humble find you, trust you and book.
Patients compare practices online before they call. We build web design for medical practices with clear service pages, provider bios, each of your locations and easy contact on every page.
Show up when patients search for care in Katy, Cypress or The Woodlands. Our healthcare SEO covers your Google Business Profile, local citations, service pages and technical fixes.
Reach patients across Harris, Fort Bend and Montgomery counties at the moment they search. We run Google Ads for doctors built around booked appointments, with keyword research and conversion tracking.
Local Facebook and Instagram campaigns with real faces, short videos and simple next steps. Our Facebook ads for medical practices follow Meta’s health rules.
Education posts, team photos, practice news and community moments that build trust with local patients, planned and posted through our medical social media marketing.
Ask happy patients for reviews, watch every new one and reply with care. Our online reputation management for doctors protects your name across the Gulf Coast.
We work with clinics and groups across Harris, Fort Bend, Montgomery and Galveston counties, from the Texas Medical Center and Memorial City to the suburbs along the Beltway 8 and I-45 corridors.
The region’s medical community, anchored by the Texas Medical Center, is heavy on specialists. Our billers know the codes, modifiers and authorizations each specialty uses most.
Stress tests, echocardiograms and cath lab procedures with the modifiers and prior authorizations payers expect.
Surgical global periods, injections and imaging, billed with the right modifiers so claims are not bundled away.
Therapy and psychiatry visits, including telehealth codes and the authorizations Texas Medicaid plans require.
High-volume office visits and preventive care where small errors add up across many claims.
Well-child visits, vaccines and CHIP or STAR Kids coverage checks before the visit.
Operative notes turned into clean claims, with global periods and assistant surgeon rules tracked.
Don’t see your specialty? We bill for 49+ specialties. See all specialties.
Texas law sets firm deadlines for filing and paying claims. Missing them costs you money, and payers who miss them owe you penalties.
| Rule | Deadline | What it means for your practice |
|---|---|---|
| Filing a claim | 95 days from the date of service | Late claims can be denied outright under Texas prompt pay rules |
| Payer decision on a clean electronic claim | 30 days | Clean e-claims should be paid or denied within 30 days |
| Payer decision on a clean paper claim | 45 days | Paper claims take longer, which is why we file electronically when payers allow it |
| Late payment penalty | After the deadline | Payers owe penalties, plus 18% yearly interest after 90 days late |
We track these dates on every claim, so late filings do not happen and late payers get followed up. Rules differ for Medicare, Medicaid and self-funded employer plans, so we check each payer before a claim goes out.
For Medicare, Texas sits in Jurisdiction H. CMS renewed the Novitas Solutions contract for this region, operational July 1, 2026, so Novitas remains the Medicare contractor for practices across the state. Texas Medicaid claims run through TMHP and each managed care plan.
Running billing in-house means hiring, training and keeping a biller who knows every local payer. It also means software, clearinghouse fees and backup when that person is away.
With outsourced billing, you keep control of your practice and your data. We work inside your systems, send regular reports and answer your team’s questions. You decide how much of the revenue cycle to hand over.
A billing company checks each patient’s coverage, reviews charges, submits claims, posts payments and works denials and unpaid claims. It also reports what was billed, paid and still open, so you always know where your money is.
Most billing companies charge either a percentage of what they collect or a flat fee per claim. The right model depends on your claim volume and specialty. We offer value-added billing at an affordable price and give you a quote after a free consultation.
Getting started
Moving your medical billing does not mean starting over. We plan the handoff around your cash flow.
1
Talk to our team by phone or on Teams. Visits to our Austin office are welcome too.
2
We review your payer mix, open A/R and how billing runs today.
3
We agree on what we take over first, so older claims keep moving.
4
We work inside your EMR, practice management software and clearinghouse.
5
Claims, posting and denials run daily. Weekly or monthly reports show the results.
We support practices across Harris, Fort Bend, Montgomery and Galveston counties, including the Texas Medical Center, Memorial City, The Woodlands, Sugar Land, Katy, Pearland and Clear Lake. We also serve practices in all 50 states.
No. Our office is at 5900 Balcones Drive STE 100 in Austin. Practices here work with us by phone, email and Microsoft Teams, and get the same team and reporting as clients who visit our office.
Yes. We bill Texas Medicaid through TMHP and its managed care plans, including STAR, STAR+PLUS, STAR Kids and CHIP, as well as Texas Medicare through Novitas Solutions.
Yes. Our teams already work in multiple billing software, including eClinicalWorks, AdvancedMD, athenahealth, Epic and NextGen, and with any clearinghouse.
Yes. Many practices start with denial management or credentialing and add more later.
Book a free consultation. We review how billing runs today and recommend where to start. We reply within one business day.
Our Austin team provides medical billing to practices across Texas and in all 50 states.
Tell us about your practice. A billing specialist will get back to you within one business day.
5900 Balcones Drive STE 100, Austin, TX 78731
Open 24 hours, 7 days a week
Talk to our billing team about your claims, denials and A/R. The consultation is free, and we reply within one business day.
