Medical Billing & Credentialing Services | Prohealthcare Advisors
- 410 Peachtree Pkwy, Suite 4245 Cumming, GA 30041
- Email: info@prohealthcareadvisors.com
- Services
Medical Billing and Practice Management
Creative Collection Solution
MD Audit Shield – RAC
Physician Credentialing
EMR/EHR Software
Electronic Fund Transfer (EFT)
CodeMAXX Services
Hippa
Built for the World's Largest Medical Complex
Houston is home to the Texas Medical Center — over 60 institutions and the largest medical complex on earth — which means Houston providers compete for staff, referrals, and payer attention in one of the densest healthcare markets in the country. We manage TMHP/PEMS Medicaid enrollment, Novitas Solutions Medicare rules, and Harris Health System coordination for independent Houston practices going up against that scale.
Houston's Distinct Healthcare Districts
Texas Medical Center Area
Practices referring into or competing alongside TMC institutions need clean facility-vs-professional billing splits and fast credentialing turnaround to keep pace.
Sugar Land & Fort Bend County
Fast-growing suburban practices with a distinct commercial payer mix from inner-Houston, requiring separate service-area verification.
Harris Health Service Area
Safety-net and FQHC-adjacent practices coordinating referrals with Harris Health System's public hospital network.
We Bill & Credential With Houston's Full Payer Mix
| Payer | Plan Type | Houston Role | Status |
|---|---|---|---|
| Texas Medicaid (TMHP / HHSC) | State Medicaid | PEMS enrollment required before MCO credentialing | Full Service |
| Medicare — Novitas Solutions | Federal Medicare | MAC Jurisdiction H | Full Service |
| Community Health Choice | Medicaid MCO | Harris County-focused plan | Full Service |
| Molina Healthcare of Texas | Medicaid MCO | Multi-region STAR plan | Full Service |
| Blue Cross Blue Shield of Texas | Commercial / MA | Dominant commercial payer | Full Service |
Medical Billing Credentialing Houston TX — FAQ
Does practicing near the Texas Medical Center change how I should bill?
Is MCO availability different in Sugar Land versus inner Houston?
Who is the Medicare Administrative Contractor for Houston?
Related Locations & Specialties
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