Podiatry Billing Services in Texas Built Around a 95-Day Filing Clock
Texas sets a 95-day claim filing deadline in statute, not in contract, and it applies to every Texas-licensed provider billing a managed care carrier. Most states leave that window to negotiation. Our podiatry billing services in Texas are built for the shorter clock:
- Daily claim submission so no encounter drifts toward the 95-day statutory deadline
- TMHP filing and 120-day appeal deadlines tracked per claim, not per batch
- Class finding review on routine foot care before Q7, Q8, or Q9 is applied
- Part B and DMEPOS claims split between Novitas and the Texas DME contractor
- Backlog recovery on unsubmitted claims still inside their filing window
- Billing module and clearinghouse failures caught before they become aged claims
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Which Texas Podiatry Practices Trust Transcure?
The Foot Clinic in Euless is a foot and ankle surgery and limb salvage practice led by Dr. Ahmed Shoukry, DPM. Its caseload produces some of the hardest claims in podiatry: diabetic wound care, reconstructive surgery, and orthotics, billed against a 95-day statutory filing clock. Transcure runs the practice’s billing operations, from submission and claim status to denials and rejections. A practice built on complex cases cannot afford a biller who batches. Claims here are worked daily, so nothing ages toward the Texas deadline.
How Do Our Texas Podiatry Billing Services Protect Every Claim?
Texas podiatry revenue is lost to the calendar more often than to the coder. A claim that is correct but late is worth nothing, and Texas gives you 95 days by law. Our medical billing services are built around that constraint.
What Texas Laws Shape Podiatry Billing Deadlines?
Transcure handles the statutory filing deadline, TMHP program rules, managed care carrier requirements, and out-of-network dispute paths. Each rule is applied at submission, so a Texas statute never becomes a Texas write-off.
The 95-Day Statutory Filing Deadline
Texas Insurance Code sets a 95-day claim filing deadline that applies to every Texas-licensed provider billing a managed care carrier, contracted or not. Most states leave that term to the contract. A practice and a carrier may agree to extend it, and our team confirms which of your contracts actually do.
TMHP Filing and Appeal Windows
Texas Medicaid requires claims within 95 days of each date of service and appeals within 120 days of the disposition date. Both windows shift to the next business day when they land on a weekend or holiday. Our team tracks each deadline per claim.
Medicaid Managed Care Compliance
Most Texas Medicaid members receive care through STAR, STAR+PLUS, or STAR Kids plans rather than fee-for-service. Each plan credentials providers and processes claims on its own terms. Our team tracks enrollment and filing status per plan.
Out-of-Network Dispute Rights
Texas gives providers a formal path to challenge out-of-network payment on protected services rather than balance billing the patient. Filing requires meeting deadlines that run alongside the claim clock. We prepare those filings instead of writing the balance off.
Which Texas Cities Get Transcure Podiatry Billing Support?
Transcure supports podiatry practices from Gulf Coast metros to West Texas markets where a single plan can dominate. Payer mix shifts hard across those regions. Our medical billing services in Texas begin each account by mapping the STAR, Medicare Advantage, and commercial plans your patients carry.
Austin, Texas
Fort Worth, Texas
Abbott, Texas
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Corpus Christi, Texas
El Paso, Texas
Plano, Texas
Irving, Texas
How Did Transcure Clear a Four-Month Backlog for a Texas Podiatry Practice?
The Foot Clinic came to Transcure with roughly four months of claims that had never been submitted. Some had already crossed the 95-day filing window. The billing module was compounding the problem, generating errors that stalled submission before anyone noticed a pattern.
Transcure took over billing operations and worked the backlog by filing deadline rather than by date of service. Claims still inside their window went first, so the recoverable revenue moved before it expired. In parallel, our team traced the module failures and built checks around them.
Daily submission and monitoring replaced batch processing, which is what keeps the backlog from returning. Claim status, denials, and rejections are now worked as they appear rather than discovered at month end. Submission timeliness holds, and the practice runs on a consistent revenue cycle instead of a recovery cycle.
Dr. Ahmed Shoukry, DPM
The Foot Clinic, Euless
“We were months behind before I understood how far behind we were. Claims were sitting unsubmitted, the billing system kept throwing errors, and every week that passed put more of that money out of reach. Transcure went after the claims that could still be filed first, which is not what I expected and is exactly what mattered. Then they fixed what was jamming the system underneath. Nothing sits now.”
Texas Counties Covered by Our Podiatry Billing Services
Transcure bills podiatry claims across all 254 Texas counties, more than any other state carries, each sitting inside its own Medicaid service delivery area with its own plan lineup. We credential your providers with the STAR plans active in your area, so no claim reaches an unenrolled plan.
Andrews County, Texas
Aransas County, Texas
Bexar County, Texas
Tarrant County, Texas
Collin County, Texas
Travis County, Texas
Podiatry Billing Services Serving Nationwide
Filing windows are the first thing that changes at a state line, and Texas runs one of the shortest in the country. Our podiatry billing teams reset the submission cadence to each state’s own deadline, from 95 days to a full year.
Which Podiatry Procedures Does Transcure Bill Across Texas?
Six procedure groups make up most Texas podiatry billing, and each fails for a different reason. Some break on Novitas coverage rules, some on STAR plan edits, and some on surgical global periods. Our coders work each group against the payer that holds the claim.
Wound Care and Debridement Billing
Codes 11042 through 11047 are chosen by the deepest tissue removed, and wound surface area sets the add-on units. Our coders take depth and size from the procedure note, not from the visit type. When the note stops at subcutaneous tissue, so does the code.
Nail Debridement Billing
Routine foot care draws heavy federal review, and nail debridement sits inside that category. A 2025 OIG audit found 49 of 100 sampled routine foot care claims did not meet Medicare requirements. Our coders confirm the qualifying systemic condition is coded before the claim is released.
Ingrown Toenail Removal Billing
Code 11730 covers the first nail avulsed and 11732 each additional nail, so every treated toe needs its own identifier. TA through T9 modifiers mark each digit, which keeps a second avulsion from reading as a duplicate. Permanent removal bills as 11750.
Bunion Surgery Billing
Bunion correction carries a global surgical period, so routine postoperative visits are already included in the surgical payment. Our surgical coders flag unrelated visits with modifier 24, staged work with modifier 58, and any plan authorization still pending. Billable postoperative care stops disappearing into the global.
Hammertoe Correction Billing
Code 28285 is reported per corrected toe, so a three-toe case needs three claim lines with three toe modifiers. The operative note must name each digit and the deformity treated there, and certified coders check it line by line. Each line then holds on review.
Custom Orthotics and DME Billing
Medicare excludes most foot orthotics by statute, so those lines carry the GY modifier and route to the patient or a secondary plan. Diabetic therapeutic shoes are a separate benefit that our DMEPOS team bills to the Texas DME contractor, with the certifying physician statement attached. Neither benefit leaks into the other.
Why Do Texas Podiatry Claims Die at 95 Days?
Because Texas puts the filing deadline in statute rather than leaving it to the contract. The Insurance Code sets a 95-day window for claims submitted to a managed care carrier, and it binds every Texas-licensed provider whether contracted with that carrier or not. Texas Medicaid applies the same 95 days through TMHP, with appeals capped at 120 days from the disposition date.
In a state with an 180-day or 12-month window, a slow month is recoverable. In Texas, a practice that falls a quarter behind has already lost claims that were clean, correct, and payable. The work was done, the documentation was fine, and the money is gone on the calendar alone.
Transcure bills Texas practices on a daily submission cycle for that reason, and works recovery by remaining days rather than by date of service. A general biller can lose payable claims to the calendar without noticing. Our podiatry billing services watch the filing date as closely as the code.
What Makes Transcure the Top Podiatry Billing Company in Texas?
Texas podiatry practices get the following from their first day with Transcure, and most of it is built around the 95-day clock.
Dedicated Podiatry Account Manager
Filing deadlines are missed when nobody owns the account. Your account manager knows which claims are closest to day 95 and answers within 2 hours. Questions reach a person, not a ticket queue.
Coding and Billing Under One Team
Practices that code in house and outsource submission carry the highest audit exposure, because nobody catches the error before it ships. Our coders and billers sit on the same account. Mistakes get caught before submission rather than during review.
Seven Dedicated AI RCM Agents
A 95-day window leaves no slack for a claim that waits on a person. ELIXA checks eligibility, PRIA files authorizations, CODIN codes, CLAIR scrubs, DEXA works denials, ARIA follows up on A/R, and REMITA posts payments. First-pass clean claims hold at 98%.
Texas Provider Enrollment and TMHP Credentialing
Our team manages CAQH profiles, Medicare enrollment, and TMHP provider enrollment for every podiatrist. STAR plan participation is tracked separately, since it does not follow state enrollment. Billing never stalls on a pending application.
Submission Timeliness Reporting
Standard reporting covers A/R aging and collections. Ours adds days-to-submission and claims approaching their filing window. In a 95-day state, that is the number that predicts the loss before it happens.
Onboarding in Under 14 Days
Most practices are live in under two weeks, including EDI and clearinghouse setup. A slow transition in Texas is not an inconvenience, it is claims aging against a statutory clock. We move before the calendar does.
Our Certifications
Transcure is ISO 27001 certified and HIPAA compliant. Our 1,100+ AAPC-certified billers apply Novitas Jurisdiction H policy and the Texas 95-day filing statute on every podiatry claim.
Which EHR Systems Support Transcure Texas Podiatry Billing?
Your Texas podiatry practice does not need to change EHRs to work with Transcure. We bill from inside 43+ EHR and practice management systems. Charge entry, claim status, and filing deadlines stay visible where your staff already works.
What Nationwide Providers Say About Transcure's Billing Services?
Podiatrists across the nation rely on Transcure to clear submission backlogs, fix the systems that caused them, and keep claims moving inside a short filing window. Here is what a few of them say.
CEO/Chief Medical Officer
Revive Community Health, AZ
“Payment posting errors and unposted recoupments had made our AR completely inaccurate. Transcure corrected all of it and put consistent claim follow-up in place at our Arizona podiatry practice.”
Pediatric Foot & Ankle Specialist
Southern California Foot & Ankle Specialists, CA
“Incorrect codes were being billed, and denials were pushing our AR up. Transcure raised it with our provider directly, and coding has been appropriate since for our California podiatry practice.”
Podiatrist
Legacy Foot and Ankle Specialists, MA
“BCBS payment delays and a large outstanding A/R were crippling us. Transcure prioritized the follow-up and recovered more than $90,000 for our Massachusetts foot and ankle practice.”
FAQs About Podiatry Billing Services in Texas
Texas podiatrists ask these questions most about deadlines, coverage, and state rules. Here are direct answers.
How long does a Texas podiatry practice have to file a claim?
Ninety-five days, set by the Texas Insurance Code rather than by contract. The deadline applies to every Texas-licensed provider submitting to a managed care carrier, whether contracted or not. Texas Medicaid applies the same 95 days through TMHP. A provider and a carrier may agree by contract to extend it.
How long do I have to appeal a Texas Medicaid podiatry denial?
One hundred twenty days from the disposition date on the Remittance and Status report. If the 95-day or 120-day deadline falls on a weekend or holiday, it extends to the next business day. Late claims are not payable, since Texas Medicaid does not cover them. Transcure tracks both windows per claim.
Which Medicare contractor processes podiatry claims in Texas?
Novitas Solutions is the Jurisdiction H A/B MAC that processes Texas podiatry claims. Texas routine foot care is judged under the Jurisdiction H policy, which Novitas keeps separate from its Jurisdiction L policy. Diabetic shoes and inserts are billed to the Texas DME contractor instead. Transcure routes each claim line to the contractor that pays it.
What happens to podiatry claims that miss the Texas filing deadline?
They are not payable, and the revenue is generally unrecoverable. This is why a submission backlog costs more in Texas than in states with 180-day or 12-month windows. Limited exceptions exist with good-cause documentation. Transcure works recovery by remaining days first, so anything still inside its window gets filed before it expires.
Does the 95-day deadline apply to out-of-state providers?
No, the statutory deadline applies to providers licensed in Texas. Out-of-state providers fall under different filing rules. Practices with providers licensed in more than one state need deadlines tracked per provider, not per practice. Transcure handles that split.
Why do Texas podiatry practices choose Transcure over other billing companies?
Texas podiatry practices choose Transcure because we submit claims daily, and a 95-day statutory window leaves room for nothing slower. Each claim is tracked by days remaining, not by date of service. Pricing is a flat 5% of collections, and onboarding takes under 14 days.
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