MSB has led the region’s ambulance billing since 1971. We understand the stress on local crews who must follow new 2026 price limits while dealing with high costs and rules for clear pricing. Our team protects your money by checking insurance instantly and using a proven system to stop insurance companies from underpaying.
By mixing 55 years of local knowledge with new tools, we do more than just collect bills. We master state rescue rules and the ban on surprise bills to keep your money safe. Our name is built on honest work, making sure every trip—from big cities to local fire districts—is billed exactly right. Joining MSB gives you the power to handle state funding programs and get extra cash for patients who cannot pay.
We utilize a strategic four-phase model to boost your revenue while navigating the Texas regulatory landscape. Our process moves quickly to keep your agency’s cash flow strong and compliant with 2026 mandates.
Phase 1: Claim Validation & Billing (Days 1–30) We prioritize 24-hour turnarounds to capture revenue under the new SB 916 inflation-capped rate limits. Our team verifies insurance immediately to stay ahead of the strict 95-day Texas Medicaid filing window and avoid rejections from major regional payers like Blue Cross Blue Shield of Texas. We ensure every claim is documented to meet DSHS licensing standards for emergency transport.
Phase 2: Managed Care Follow-up (Days 31–60) Our specialists aggressively pursue unpaid claims from carriers like Superior HealthPlan and Molina Healthcare. We handle technical appeals for SB 1264 and SB 2476 “surprise billing” disputes, using the Texas Independent Dispute Resolution (IDR) portal to recover maximum revenue. This keeps patients protected from balance bills while securing the fair market rates your crew has earned.
Phase 3: Formal Collections & Notice (Days 61–90) Unpaid accounts move to a stage governed by Texas Finance Code Chapter 392. We send professional notices that follow state-specific debtor protections, including strict rules on contact timing and validation. Our process protects your agency’s reputation while encouraging payment through transparent pricing disclosures and flexible arrangements that fit the local economy.
Phase 4: Final Recovery & Review (Day 91+) For difficult accounts, we review options within the four-year statute of limitations. We utilize every compliant resource, including the Ambulance Services Supplemental Payment Program (ASSPP) and the new HB 3000 rural grants, ensuring your Emergency Services District (ESD) receives its rightful funding before the legal window for recovery expires.
At MSB, we do things the right way. We know that billing for rescue trips is about more than money—it is about caring for your patients. Our team knows the 2026 Texas rules and follows them to keep your agency safe.
We follow the state's Fair Debt Collection laws to keep your name clean. We send polite reminders and follow all rules that stop pushy or unfair collection habits.
State law stops patients from getting huge, hidden bills for emergency rides. We talk to the insurance companies for you to make sure you get a fair payment without asking the patient for extra money.
We help you follow state price rules by giving patients clear info on costs. We also handle the paperwork to make sure your 2026 price updates follow the law so your claims don't get turned down.
By joining MSB, you work with a team that values honesty and hard work, just like your local rescue squad.
Picking MSB means having a partner who knows the area inside and out. We do more than just send bills; we fix the daily problems that local rescue teams face. With 55 years of experience, we turn messy paperwork into steady cash for your team.
MSB works with you to fix the problem of unpaid insurance bills. We use 55 years of work and new tools to get back the money your crew earned.
Discover the experiences of our satisfied clients. Hear firsthand Midwest Service Bureau Reviews on how MSB has delivered reliable, results-driven solutions that make a real difference.
Unpaid bills may be referred to specialized collectors. While Texas protects your primary home, consistent non-payment can lead to formal recovery efforts under state debt collection laws.
Under 2026 standards, major bureaus exclude most medical debt. However, we focus on ethical resolution to ensure your financial standing remains protected throughout the entire billing process.
You can settle by contacting our Texas billing office directly. We offer various settlement options to resolve your balance quickly while ensuring your account is marked as satisfied.
Yes. In compliance with Texas transparency rules, we provide flexible, interest-free payment plans designed to fit your monthly budget while maintaining your account in good standing.
Typically, accounts move to collections after 90 to 120 days of non-payment. We provide multiple notices before this transition to help you find a suitable financial solution.
You may request a review based on financial hardship or insurance underpayment. Our team evaluates these requests to find a fair, mutually agreeable resolution for all parties involved.
It means a specialized team now manages your account. They will work with you to arrange payment while following strict Texas Finance Code ethical communication and validation rules.
Ready to improve your commercial organization’s revenue cycle? Contact our specialists today.
Email: client@msbureau.com
Phone: 316-263-1051
Address: 625 W. Maple St., Wichita, KS 67213
Texas ambulance billing faces unprecedented complexity with the nation’s highest uninsured rate at 18%, creating massive bad debt burdens for EMS providers while navigating diverse payer requirements across the state’s 254 counties.
Texas’s EMS payer mix reflects significant uninsured populations and limited Medicaid expansion. Typical distributions show: Medicare 29%, Medicaid 24%, Commercial Insurance 29%, and Self-pay/Uninsured 18%. This high self-pay percentage creates severe collection challenges requiring sophisticated financial counseling and alternative payment strategies.
The dominant commercial payers in Texas include Blue Cross Blue Shield of Texas, United Healthcare, Aetna, Cigna, and Humana. Average reimbursement rates vary dramatically by region and network contracts. Medicare pays approximately $445 for BLS transports and $680 for ALS transports. Commercial insurers typically reimburse 125–175% of Medicare rates, while Texas Medicaid reimburses just $265 for BLS and $415 for ALS transports.
Collection rate challenges intensify with Texas’s large uninsured population. EMS providers report average collection rates of 61% for commercial insurance, 97% for Medicare, 93% for Medicaid, but only 5–8% for self-pay accounts. The combination of high self-pay volume and low collection rates devastates Texas EMS billing recovery efforts.
Schedule a demo today—24-hour turnaround to implement proven strategies for Texas’s challenging payer environment.
Texas Medicaid’s fee-for-service and managed care programs create dual compliance requirements. Current reimbursement rates stand at $265.50 for BLS emergency transports and $415.75 for ALS emergency transports, with mileage reimbursed at $3.95 per loaded mile. Managed care organizations, including Superior HealthPlan, Molina Healthcare, and UnitedHealthcare Community Plan, each maintain distinct policies.
Timely filing limits require claims submission within 95 days from the date of service for Texas Medicaid fee-for-service, while MCOs typically allow 90-180 days. The Texas Health and Human Services Commission oversees Medicaid compliance, requiring strict adherence to billing codes and documentation standards.
The No Surprises Act implementation affects Texas ambulance debt compliance through state-specific balance billing laws. Senate Bill 1264 preceded federal NSA requirements, establishing protections for emergency services. While ground ambulance services aren’t included in either law, Texas providers must navigate complex disclosure requirements.
Prior authorization isn’t required for emergency transports, but becomes mandatory for non-emergency services, with specific requirements varying by MCO.
Texas’s FDCPA implementation includes state-specific provisions through the Texas Finance Code Chapter 392. Collection agencies must obtain surety bonds and comply with strict licensing requirements through the Office of Consumer Credit Commissioner. Texas maintains some of the strongest debtor protections in the nation.
Specific collection restrictions include prohibited contact at unusual times or places, limitations on third-party communications, and mandatory validation notices. Texas emergency medical transport collections face additional restrictions, including prohibitions on collecting from certain protected income sources and strict garnishment limitations.
The statute of limitations for medical debt in Texas is four years from the date of service or last payment. Texas law provides extensive debtor protections, including complete wage garnishment prohibition for consumer debts, unlimited homestead exemptions, and protection of retirement accounts.
Schedule a demo today—24-hour turnaround to navigate Texas’s complex collection environment compliantly.
Texas’s EMS landscape encompasses everything from major urban fire departments to volunteer services covering vast rural territories. Major hospital systems, including HCA Healthcare, Tenet Health, CHRISTUS Health, Methodist Healthcare, and Texas Health Resources, significantly influence regional EMS operations.
The 911 versus private EMS structure varies dramatically across Texas’s diverse regions. Houston, Dallas, San Antonio, and Austin operate municipal fire-based EMS systems with private services handling non-emergency transports. Fort Worth contracts with MedStar for all EMS services. Rural counties utilize various models from hospital-based services to volunteer fire departments with EMS capabilities.
Average transport distances reflect Texas’s immense size. Urban transports average 5-12 miles, while rural West Texas transports routinely exceed 50-75 miles. Critical care transfers from rural facilities to major medical centers can surpass 200 miles. Unique contracting norms include widespread use of emergency services districts (ESDs) for funding, extensive mutual aid agreements crossing county lines, and increasing adoption of community paramedicine programs in both urban and rural settings.
In Houston, Harris County ESD-11 (Cypress Creek EMS) reduced its 120-day A/R from $5.2 million to $2.7 million by implementing comprehensive insurance discovery and early-out self-pay programs. The service partnered with specialized ambulance collection professionals to address their 18% uninsured rate. By deploying advanced eligibility screening technology and establishing hospital partnership programs for retroactive coverage identification, they improved insurance capture by 34% and increased self-pay collections from 5% to 12%. The system enhanced Texas’s surprise billing ambulance compliance through transparent pricing communications and flexible payment arrangements.
According to the Texas Department of State Health Services 2023 EMS/Trauma Registry Report, statewide uncompensated care for ambulance services exceeded $450 million annually.
Schedule a demo today—24-hour turnaround to implement strategies that maximize revenue in Texas’s challenging environment.
Our ambulance collection services ensure 100% compliance with Texas state regulations, federal requirements, and complex managed care contracts. Contact Midwest Service Bureau’s Texas ambulance billing specialists today at 316-263- 1051 for a confidential consultation.
