Texas Medical Billing: Medicare, Medicaid, and Auto Injury Claims
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Full transcript
Overview
Texas practices need billing workflows that keep Medicare claims, Medicaid managed care, auto injury coordination, and denial follow-up clearly organized.
Medicare contractor
Medicare claims are handled through Novitas Solutions JH, and that contractor path matters for claim processing questions and first-level Medicare appeals.
Medicaid program
Medicaid runs as Texas Medicaid STAR and is delivered through commercial managed care plans, so many Medicaid claims follow plan-specific filing windows and authorization requirements.
Auto injuries
Texas is treated as a tort state for auto injuries, so standard coordination of benefits applies rather than a no-fault carrier taking first position.
Coverage and pricing
Local coverage determinations can also affect whether the same service is covered in Texas but handled differently in another state.
Coding, claims, and follow-up
These details shape certified coding, claim scrubbing, electronic submission, denial management, appeals, payment posting, accounts receivable follow-up, coordination of benefits, patient billing, and support.
The takeaway
For Texas practices, the goal is to keep payer responsibility clear, claim files complete, and revenue cycle work moving without avoidable confusion
What is different about billing in Texas?
- Medicare contractor
- Novitas Solutions (JH)
- Medicaid program
- Texas Medicaid (STAR)
- Medicaid delivery
- Commercial managed care plans
- Auto injuries
- Tort: standard coordination of benefits
Want your Texas claims worked for you?
We code, submit, and follow up on claims for Texas practices, with Medicare appeals worked to Novitas (JH) and Medicaid billed to Texas Medicaid (STAR). Tell us about your practice and we'll send a written scope and price.
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White Glove Medical Billing is a medical billing, coding, and revenue cycle company — not a healthcare provider and not a law firm. All coding is performed by certified coders from your providers' documentation; the clinical record and the certification of medical necessity remain the provider's.