Billing and Payers Information



BILATERAL BILLING GUIDE – A guide on the bilateral billing requirements of the major Houston market health plans. 


EVALUATION AND MANAGEMENT CODING TOOL – Revamped from an AAFP Family Practice Management journal, a coding tool to assist physicians with proper E/M coding and auditing. 

HCMS PAYMENT ADVOCACY PROGRAM - The Harris County Medical Society offers a payment assistance program at no charge to our members to assist them with payment issues.  




LOCUM TENENS - Guidance on locum tenens rules and billing protocols.


NATIONAL DRUG CODE (NDC) CALCULATOR - This spreadsheet calculates the NDC billing units to be populated on the NDC claim line. See our NDC Billing Guidelines for more information on NDC billing requirements.


PAYERS  - Information on the various payers in the Houston market.        


PHYSICIAN EXTENDERS - Information on billing for physician extenders.  

PROMPT PAYMENT DISCOUNTS - Guidance and rules for prompt payment discounts for patients.


PROMPT PAY PENALTIES - Prompt Pay Penalties Fact SheetPrompt Pay Penalty Guide, and Underpayment Penalty Calculator - Resources to determine prompt pay penalties and regulations by payer type.


RECOUPMENTS - Rules and information regarding recoupments.  


TELEMEDICINE/TELEHEALTH - Rules, legislation, and resources.


WHERE TO FILE COMPLAINTS - Information on where to file complaints against various payers.