Medical billing services for San Antonio practices
SFA Solutions bills for San Antonio practices remotely from our Austin office, about 80 miles up I-35, working inside the EHR and PM system you already use. Our U.S.-based team works the Bexar service area Medicaid plans, TRICARE and Medicare Advantage claims that make up much of a typical San Antonio payer mix.
Remote service from our Austin, Texas headquarters. No EHR migration required.
The Bexar service area
San Antonio practices fall in HHSC's Bexar Medicaid managed care service area: Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina and Wilson counties. STAR is offered by Aetna Better Health, Community First Health Plans, Superior HealthPlan and Wellpoint. Community First is the local plan affiliated with University Health and is the only plan here in STAR, STAR+PLUS, STAR Kids and CHIP, which makes it a key contract for most Medicaid practices in the area.
TRICARE in Military City USA
Joint Base San Antonio and Brooke Army Medical Center bring a large active duty, family and retiree population. Texas moved to the TRICARE West Region on January 1, 2025, so network contracts, referrals and claims for TRICARE Prime and Select patients now run through TriWest Healthcare Alliance. Retirees 65 and older usually have TRICARE For Life, where Medicare pays first and TRICARE pays second, so the Medicare claim has to be right before the secondary will pay.
Public, academic and system hospitals
University Health is the Bexar County hospital system and works with UT Health San Antonio, the city's academic medical school. Methodist Healthcare, Baptist Health System and CHRISTUS Santa Rosa run the other major hospital networks, many of them in the South Texas Medical Center area on the northwest side. Independent physicians who see patients at those hospitals need facility place of service codes on hospital visits and office codes on clinic visits, since the two pay at different rates.
Medicare Advantage in Bexar County
CMS data from March 2025, compiled by the RUPRI Center, shows 63.2% of Medicare-eligible Bexar County residents enrolled in Medicare Advantage, compared with 58.9% statewide. Senior visits therefore go mostly to MA plans with their own prior authorization rules, while traditional Medicare claims go to Novitas Solutions in Jurisdiction H. We confirm plan type at each visit, which matters most for retirees who may have Medicare, an MA plan or TRICARE For Life.
Bexar service area
HHSC announced new STAR and CHIP contract awards in 2024, but a Travis County court blocked them in October 2024 and the state appealed. HHSC's service area map revised in January 2026 still shows the plans listed here, so treat this list as current for now and confirm the member's plan in TMHP or the plan portal before each visit.
- Community First Health Plans (STAR, STAR+PLUS, STAR Kids, CHIP)
- Aetna Better Health of Texas (STAR, CHIP)
- Superior HealthPlan (STAR, STAR Kids, CHIP; STAR Health statewide)
- Wellpoint (STAR, CHIP)
- Molina Healthcare (STAR+PLUS)
- UnitedHealthcare Community Plan (STAR+PLUS)
Major health systems in the area
- University Health
- UT Health San Antonio
- Methodist Healthcare
- Baptist Health System
- CHRISTUS Santa Rosa Health System
- Brooke Army Medical Center
- South Texas Veterans Health Care System
Specialty mix
San Antonio's practice mix includes a large primary care and pediatric base with significant Medicaid and CHIP volume, specialty groups clustered near the South Texas Medical Center, and practices that see many military families and retirees. Practices near the military bases need TRICARE West referral and authorization rules down cold, and practices with older patients need secondary claim handling for TRICARE For Life and Medicare supplements. Primary care and pediatrics carry the most MCO eligibility and 95-day filing risk.
Also serving practices in New Braunfels, Boerne, Schertz, Seguin, Converse, Helotes, Live Oak, Universal City.
San Antonio medical billing questions
Which Medicaid plans operate in the Bexar service area?
STAR is offered by Aetna Better Health, Community First Health Plans, Superior HealthPlan and Wellpoint. STAR+PLUS is offered by Community First, Molina and UnitedHealthcare, and STAR Kids by Community First and Superior.
Who handles TRICARE claims for San Antonio patients?
Since January 1, 2025, Texas has been in the TRICARE West Region, administered by TriWest Healthcare Alliance. TRICARE For Life claims for retirees with Medicare are billed to Medicare first, and TRICARE pays as secondary.
Do you have an office in San Antonio?
No. Our office is in Austin, and we work with San Antonio practices remotely inside your existing EHR or PM system. You have a named account manager who knows your payers.
How do we start?
Request a free practice audit. We review your billing and walk you through where revenue may be slipping, with no commitment. Service is month-to-month with 60 days' notice.
Sources
- Texas HHSC: Medicaid and CHIP managed care service areas map (MCOs as of January 2026)
- Texas HHSC STAR+PLUS Handbook, Appendix XXXVIII: service areas by county
- RUPRI Center: Texas Medicare Advantage enrollment by county (CMS data, March 2025)
- TRICARE: Contract transition frequently asked questions (Texas moved to the West Region in 2025)
- CMS: A/B MAC Jurisdiction H (Novitas Solutions)
More Texas pages: Texas · Austin · Dallas · Fort Worth · Houston
Find out where your practice may be losing revenue
Request a free practice revenue audit. We review your billing and walk you through where revenue may be slipping. No commitment, and no patient records are required to request an initial review.