If your Plano practice is losing time to denials, underpayments or aging A/R, The Medical Billing can take over billing and coding end to end. We work with physicians, specialty groups and labs across Collin County, Texas.
Medical Billing for Plano's Healthcare Market
Healthcare in Plano is anchored by Medical City Plano, Texas Health Presbyterian Hospital Plano and Baylor Scott & White – Plano. Independent practices here refer to — and receive referrals from — those systems every day, which means accurate referring-provider data, prior authorizations and place-of-service coding are essential to getting paid. We set up those details correctly at charge entry instead of fixing them after a denial.
Texas Payer Rules We Handle for Plano Practices
- Medicare: Part B claims go to Novitas Solutions; Medicare Advantage claims go to the patient's private plan with its own authorization rules.
- Medicaid: Texas Medicaid is run by the Texas Medicaid & Healthcare Partnership (TMHP), and most members are in STAR, STAR+PLUS, STAR Kids and STAR Health managed care plans.
- Commercial plans: we bill Blue Cross and Blue Shield of Texas, UnitedHealthcare, Aetna and Cigna and the employer plans common in Collin County.
- Local detail: Commercial PPO and HMO claims fall under the Texas prompt-pay rules, and we track payment timelines so late or underpaid claims are escalated instead of forgotten.
What's Included for Plano Practices
- Insurance eligibility and benefits verification before each visit
- Medical coding (CPT, ICD-10-CM, HCPCS and modifiers) by certified coders
- Charge entry and claim scrubbing to catch errors before submission
- Electronic claim submission to Medicare, Texas Medicaid plans and commercial payers
- Denial management and appeals with root-cause tracking
- A/R follow-up on aging claims, worked daily
- Payment posting from ERAs and EOBs, including underpayment checks
- Credentialing and payer enrollment, including TMHP provider enrollment
- Monthly reporting on collections, denials and days in A/R
Why Plano Practices Outsource Billing to Us
An in-house biller has to know every payer rule, every code change and every portal. Our team already does. Plano practices that outsource to us get specialist coders, daily denial follow-up and clear monthly reporting without adding payroll or software costs.
We also support practices in Frisco, Allen, McKinney and Richardson, and across the rest of the state — see our Texas medical billing services or nearby pages for Houston and San Antonio. Specialty groups can read more about our physician billing and hematology billing services.
Specialties We Bill For in Plano
Frequently Asked Questions
Do you provide medical billing services in Plano, TX?
Yes. We work remotely with physician practices, clinics, specialty groups and labs in Plano and across Collin County. We handle coding, claims, denials and A/R follow-up for Medicare, Texas Medicaid and commercial payers.
Which insurance payers do you bill for Plano practices?
Medicare Part B through Novitas Solutions, Medicare Advantage plans, Texas Medicaid and its managed care plans, and commercial payers such as Blue Cross and Blue Shield of Texas, UnitedHealthcare and Aetna.
Do you work with practices near Plano?
Yes — including Frisco, Allen, McKinney and Richardson. Billing is done remotely, so practices anywhere in Texas can work with us.
How much does medical billing cost for a Plano practice?
Most billing companies charge a percentage of monthly collections, commonly between 4% and 10% depending on specialty and claim volume. We give you a fixed quote after a free audit of your claims and A/R.
How long does it take to switch to your billing service?
It depends on how quickly payer and EHR access can be set up. We plan the transition so that existing A/R keeps being worked while new claims move to our team, and we share a timeline after the free audit.