Medical Billing Services in San Antonio, Texas

Medical billing services in San Antonio and across South Texas

Fastora provides medical billing services in San Antonio for physician practices, therapy clinics, behavioral health groups and multi-location practices across the region. We are headquartered in Austin and work remotely inside your EHR/PM system, so San Antonio practices get the same process without a local office visit. When practices compare San Antonio medical billing services, the questions that matter are Texas-specific: which Medicaid service area the patient falls in, how TRICARE authorizations are tracked, and whether the team works inside your existing systems.

As a medical billing company in San Antonio, we work with two features that define billing here: the Bexar Medicaid service area, which sets the managed care plans your patients can have, and one of the largest military health footprints in the country, which brings TRICARE and VA community care billing into everyday practice. The sections below cover both, plus the checks we run on every claim.

The Bexar Medicaid service area

HHSC divides Texas into managed care service areas, and San Antonio sits in the Bexar service area - one area covering the metro and its surrounding counties, unlike Dallas-Fort Worth which is split across two. The STAR, STAR+PLUS and STAR Kids plans available to a member depend on the county where they live.

The corridor cities matter for billing because growth is pushing practices outward. A pediatric group with offices in San Antonio and New Braunfels is still in one service area - Comal County is in Bexar - but a Boerne location sits in Kendall County, and scheduling and eligibility staff need to know that both are Bexar service area counties with the same MCO lists. We confirm each member's program and MCO on the date of service and keep a payer setup sheet for every plan your practice is contracted with.

The Texas Medicaid billing guide explains TMHP and MCO claim routing in more detail.

Military, TRICARE and VA billing in San Antonio

Joint Base San Antonio - Lackland, Fort Sam Houston and Randolph - plus Brooke Army Medical Center make the San Antonio area one of the densest military health markets in the country. Practices here see active-duty families, retirees and veterans every day, which means TRICARE and VA community care claims are routine, not occasional.

TRICARE billing has its own discipline. Referrals and authorizations follow TRICARE West rules, and the requirements differ between TRICARE Prime, TRICARE Select and TRICARE for Life. Active-duty service members generally need referrals for civilian care, and missing or expired authorizations are the most common reason TRICARE claims deny. We verify TRICARE eligibility and authorization status before the visit and track referral expirations so they do not lapse mid-treatment.

VA community care adds another workflow: veterans referred to civilian providers under VA community care need a VA authorization on file, and the claim goes to the VA's claims processor, not to the patient's other insurance, when the VA authorized the care. Mixing up the payer order is the classic VA billing error. We confirm the authorization and the correct payer before billing starts.

Medicare Part A and B claims for Texas go to Novitas Solutions, the Jurisdiction H Medicare Administrative Contractor - relevant for the area's large TRICARE for Life and Medicare-eligible retiree population, where coordination between Medicare and TRICARE has to be right for secondary claims to pay.

Practices we support in San Antonio

Medical billing in San Antonio covers a wide spread of specialties and practice sizes. These are the billing details we focus on for common practice types.

For therapy practices, our 8-minute rule calculator shows how timed minutes convert to billable units, and our physical therapy billing guide covers the documentation behind the units.

How our team works with South Texas practices

We do not have an office or staff in San Antonio. Our team works remotely from Austin, through the user access your practice grants in your EHR/PM system. Each practice gets a dedicated account contact, transparent dashboards, monthly performance reporting and a monthly review call by video.

Our work follows three phases: a Virtual Assistant phase for scheduling, registration, insurance verification and co-pays collected upfront; a Scriber phase that records visit documentation in your EHR in real time; and a billing phase for claim submission, payment posting, denial management, AR follow-up and patient billing. You can use all three or only the billing phase. See the full list of our medical billing services.

Credentialing services in San Antonio for growing groups

Groups that expand across Bexar and the surrounding counties need enrollment updated for each new provider and location. Our credentialing services for San Antonio practices follow a tracked nine-stage process: consultation, document collection, state licensing, NPI and CAQH setup, payer applications, panel submissions, follow-ups, final approval and ready to bill.

For Texas Medicaid, enrollment through TMHP comes first, then credentialing with each MCO in the Bexar service area. Commercial credentialing runs in parallel, and TRICARE network enrollment is handled where the practice wants it. Read about provider credentialing and enrollment.

Questions to ask medical billing companies in San Antonio

When you compare medical billing companies in San Antonio, these questions show how well a team understands South Texas billing.

1. How do you verify TRICARE referrals and authorizations before the visit?
2. How do you handle VA community care authorizations and payer order?
3. How do you confirm a Medicaid member's MCO on the date of service in the Bexar service area?
4. How are new locations added to Medicare and payer enrollment?
5. What will you report each month, and who is our contact?
6. How is pricing set, and are there setup fees? Our pricing models are explained up front.

Compare coverage in Austin medical billing services and Dallas-Fort Worth medical billing services if your group sees patients in other Texas metros.