An Austin-based billing team for practices in Austin, Houston, Dallas and across the state. We know the state’s payers, its deadlines and the systems you already use.
Headquartered at 5900 Balcones Drive, Austin
Prime Medical Revenue provides medical billing services in Texas from our office in Austin. We check coverage before visits, file clean claims, post payments and work denials for practices from the Gulf Coast to North Texas.
Plenty of medical billing companies in Texas are run from other states. Our team works with these payers every day. We know how Novitas handles Medicare claims, how TMHP and the STAR managed care plans process Medicaid, and how Blue Cross Blue Shield of Texas edits commercial claims.
That local knowledge shows up in fewer denials and faster follow-up, because the rules are already familiar.
Our process is the same in every city. What changes is the local payer mix, and our team already knows it.
We work inside your EMR, practice management software and clearinghouse. Our teams already bill in multiple billing software, so there is no forced switch.
Denied claims are worked before anything else, appealed within filing limits and traced to the root cause.
Weekly or monthly reports show what we filed, what was paid and what is still open.
We keep your fee schedules updated under CMS guidelines so charges match what you should be paid.
Hand over the full cycle, pick individual services, or begin with an audit.
Meet your team at 5900 Balcones Drive, or talk by phone and Microsoft Teams.
Our Austin office supports practices statewide. Each city page covers local payers, neighborhoods and specialties.
Billing in this state has its own contractors, Medicaid programs and deadlines. Here is what our team tracks on every claim.
Novitas Solutions (Medicare JH)
Medicare Part A and B claims in Texas
Code to Novitas local coverage rules and edits
TMHP
Texas Medicaid fee-for-service and enrollment
Verify eligibility and follow TMHP filing rules
STAR, STAR+PLUS, STAR Kids, CHIP
Texas Medicaid managed care plans
Check each plan’s authorization list before the visit
Blue Cross Blue Shield of Texas and other commercial plans
Most employer-sponsored coverage
Scrub claims against each payer’s edits
Texas prompt pay rules
Fully insured HMO and PPO plans
File within 95 days; follow up at 30 or 45 days
Novitas remains the Medicare contractor for Texas. CMS renewed its Jurisdiction H contract, which became operational on July 1, 2026. Under state prompt pay rules, payers must pay a clean electronic claim within 30 days and a clean paper claim within 45 days, or owe penalties.
Sources: CMS Jurisdiction H fact sheet and Texas Department of Insurance.
We bill for 49+ specialties. Some of the most requested across the state:
High volume, fast turnaround and eligibility checked at check-in.
Therapy, psychiatry and telehealth claims with the right codes and authorizations.
Testing and procedures with prior authorization confirmed up front.
Surgery, injections and imaging with modifiers and global periods tracked.
Preventive care, vaccines and chronic care management billed accurately.
Timed codes and visit limits followed on every claim.
See the full list on our specialties page.
Some practices want help with one step. Others want the whole cycle handled. Our revenue cycle management services cover eligibility, coding checks, claims, posting, denials and reporting as one workflow, with one point of contact.
You can also start small. Many practices begin with a billing audit or credentialing and add services later.
Each service works on its own or as part of the full revenue cycle. Read the short summary, then follow the link for the full details.
One team runs the full cycle, from the eligibility check to the final payment, for practices in Austin, Houston, Dallas and beyond. Our medical revenue cycle management works inside your current EHR.
Texas Medicaid runs through TMHP and managed care plans such as STAR, STAR+PLUS, STAR Kids and CHIP. Our patient eligibility verification checks coverage and prior authorization for each plan before the visit.
A state-regulated payer has 30 days to pay a clean electronic claim, but only if it is clean. Our claim submission services scrub every claim and file it well inside the 95-day state filing window.
New providers need enrollment with Medicare, Texas Medicaid and each commercial plan before they can bill. Our provider credentialing services handle CAQH, applications and follow-up until every panel is approved.
Blue Cross Blue Shield of Texas, UnitedHealthcare, Aetna, Cigna and Humana each set their own appeal windows. Our denials management services work every denial inside those limits and fix the root cause.
Every ERA, EOB and check is posted to the right charge and compared with your fee schedule. Our payment posting team flags underpayments, so you know exactly what each payer paid.
See where revenue is slipping before you change anything. As a medical billing audit company based in Austin, we review coding, charge capture, claim quality and A/R, then hand you a clear fix plan.
Our medical coding service matches CPT, ICD-10-CM and HCPCS codes to each note, so claims carry the codes, E/M levels and modifiers your documentation supports.
Solo and small offices from El Paso to Beaumont can outsource medical practice billing to one specialist who knows the practice, without the cost of building an in-house team.
Hospitals surveyed by Premier Inc. said nearly 15% of claims to private payers were denied at first. Fighting each denial cost an average of $43.84, and more than half of those denials, 54.3%, were later overturned and paid.
On HealthCare.gov plans, insurers denied 19% of in-network claims in 2024, and fewer than 1% of those denials were appealed, according to KFF.
Most of that money is recoverable, but only if someone works the denial in time. State rules give practices 95 days to file and set strict payment deadlines for payers. A billing team that tracks both sides keeps more of your revenue.
Sources: Premier Inc. and KFF. See our denial management services.
Billing keeps revenue flowing. These services help more patients find you, trust you and book.
Patients in every city compare practices online first. Our medical office website design gives you clear service pages, location pages, provider bios and easy contact paths.
Show up in Google search and Maps across Austin, Houston and Dallas. Our medical website SEO covers your Google Business Profile, local citations, service pages and technical fixes.
Reach patients in your area at the moment they search. Our healthcare PPC management builds campaigns around booked appointments, with conversion tracking and clear reports.
Local Facebook and Instagram campaigns with real faces and clear offers. Our medical Facebook ads follow Meta’s health rules and use broad, safe targeting.
Education posts, team photos and practice news for your patients, planned and published through our healthcare social media services.
Reviews often decide which practice a patient calls first. Our medical reputation management requests reviews, monitors every profile and drafts careful replies.
Getting started
A planned handoff that protects your cash flow, whether you are in Austin, Houston, Dallas or anywhere else in the state.
1
Talk to our team at our Austin office, by phone or on Teams.
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 have dedicated pages and support for Austin, Houston and Dallas, and we work with practices anywhere in the state. We also serve practices in all 50 states.
Yes. We bill Texas Medicaid through TMHP and its managed care plans, including STAR, STAR+PLUS, STAR Kids and CHIP.
Our headquarters is at 5900 Balcones Drive STE 100, Austin, TX 78731. We are open 24 hours a day, 7 days a week.
Yes. Our Austin team supports practices in all 50 states. See the states we serve.
Book a free consultation. We reply within one business day.
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
Tell us about your practice and payer mix. The consultation is free, and we reply within one business day.
