Specialized Revenue Cycle Management in Texas
Mediknocx runs the revenue cycle for Texas practices from eligibility checks to final payment. We're built around the payers that decide your cash flow: Blue Cross and Blue Shield of Texas (BCBSTX), whose parent company holds about 44% of the state's commercial market, and Texas Medicaid, where most patients are enrolled in STAR, STAR+PLUS, or STAR Kids managed care plans.
HIPAA Compliant
Your data stays secure
Faster Payments & Fewer Denials
Improve cash flow
Higher Reimbursement
Get the revenue you deserve
Texas Billing Compliance Experts
State-specific payer knowledge
Get Your Free Revenue Assessment
Find out how much revenue your practice could be recovering with expert revenue cycle management support. No obligation, just real insights.
Specialized Revenue Cycle Management in Texas: Miss the 95-Day Filing Deadline and You Forfeit Payment
Texas-licensed physicians must submit claims to PPO insurers and HMOs within 95 days of the date of service (Tex. Ins. Code ยงยง 1301.102 and 843.337). A claim filed late isn't just delayed. The provider forfeits the right to payment, and the rule applies whether or not you're contracted with the plan. In return, carriers must act on clean claims within 30 days when filed electronically and 45 days on paper.
Texas Medicaid runs on the same short clock. TMHP requires claims within 95 days of service in most cases, with an outer federal limit of 365 days for exceptions like retroactive eligibility. Secondary claims have their own 95-day window, counted from the date the primary payer's payment is determined. For a practice juggling BCBSTX, Medicare Advantage, and several Medicaid plans, 95 days goes quickly.
Expertise
Built for local care models
Deadline Tracking
We flag at-risk claims early
Fewer Denials
Correct coding, less revenue loss
The Full Revenue Cycle We Manage in Texas
- Patient Access & Eligibility Verification: Confirm coverage and Medicaid plan assignment before every visit, and check whether a gold card exemption removes the need for prior authorization.
- Charge Capture & Coding: Certified coders match CPT, ICD-10-CM, and HCPCS codes to documentation.
- Claims Submission: Clean electronic claims go out well inside the 95-day window.
- Payment Posting: ERAs are checked against contracted rates; late payments are flagged.
- Denial Management & Appeals: Timely filing denials are challenged with submission proof.
- AR Follow-Up: Secondary claims are filed within 95 days of the primary payer's decision.
- Reporting: Monthly reports on collections, denials, and AR days.
How It Works
From Audit toFaster Payments in 4 Steps
A simple, proven process to streamline your revenue cycle and maximize reimbursements in Texas.
Free Audit
We review your claims, denials, and AR aging.
Custom Plan
A written plan built for your payer mix.
Seamless Transition
We connect to your system with no gap in claims.
Ongoing Reporting
Monthly reports show exactly where your revenue stands.
Get Your FreeRevenue Cycle Audit Report
Losing claims to the 95-day deadline? Call +1 434-201-9720 or email info@mediknocx.com for a free revenue cycle audit.
What Makes Our Texas
Revenue Cycle Management Different
One team owns every stage of your cycle, not just claim submission.
Full-Cycle Ownership
One team runs eligibility, coding, claims, posting, denials, and AR, so a problem found in follow-up gets fixed where it started instead of repeating on next month's claims.
BCBSTX and Medicaid Focus
We work BCBSTX policies alongside the separate rules of each STAR, STAR+PLUS, and STAR Kids plan, so every claim meets the requirements of the payer that actually covers the patient.
95-Day Deadline Tracking
Every open claim is tracked against its own filing deadline, including secondary claims and retro-eligible Medicaid patients, so no eligible revenue is forfeited because a date quietly slipped past.
Monthly Reporting Cadence
You receive a clear monthly report on collections, denial rates, and AR days by payer, with plain notes on what changed since last month and what we're doing next.
Compliance Built In
Our workflows follow HIPAA requirements, the No Surprises Act, and Texas billing law, and we update them whenever TDI, HHSC, or a commercial payer publishes a rule or policy change.
Specialty Depth
Coders assigned to your specialty know its code sets, so they catch modifier errors and bundling issues that general billers often miss, which keeps more claims clean on the first pass.
Specialty Expertise That Works for You
Mediknocx supports revenue cycle management for 47 medical specialties, including family practice, internal medicine, cardiology, orthopedics, pediatrics, OB-GYN, behavioral health, and pain management. Team members are assigned by specialty.
How Does Mediknocx Ensure Compliance
With Texas Medical Billing Regulations?
No Surprises Act
Good faith estimates and balance billing limits are applied for self-pay and out-of-network patients.
Texas Timely Filing Law
Commercial PPO and HMO claims are filed within 95 days of service, and Texas Medicaid claims meet TMHP's 95-day and 365-day deadlines.
Texas Billing Transparency & Itemization
Under Texas Health and Safety Code Chapter 185 (SB 490), patient bills include an itemized, plain-language list of each service. A provider can't pursue collection without one.
Payer-Specific Guidelines
We follow the published policies of BCBSTX, each Texas Medicaid managed care plan, TMHP, and Medicare.
Healthcare Billing Services Across Texas Cities
We serve healthcare providers in Houston, Dallas, San Antonio, and across the state.
- Houston
- San Antonio
- Dallas
- Fort Worth
- Austin
Nationwide Revenue Cycle Management
Mediknocx also supports practices in Alaska, Connecticut, Maine, Montana, New Hampshire, North Dakota, Oregon, Pennsylvania, Rhode Island, and South Dakota.
Ready for a revenue cycle that never runs out the 95-day clock? Start with a free audit from our RCM team. Reach us at +1 434-201-9720 or info@mediknocx.com.
Frequently Asked Questions
Find answers to the most common questions about our revenue cycle management services in Texas.
