Medicaid billing in every state
Fee-for-service Medicaid and Medicaid managed care billing, state provider enrollment, MCO credentialing and the state-specific rules that make Medicaid different everywhere.
Working with Medicaid
Each state runs its own Medicaid program with its own fee schedule, covered services, prior authorization rules and filing limits. In most states, the majority of members are enrolled in Medicaid managed care organizations (MCOs), and each MCO has its own portal and policies.
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Plan types we bill:
- State fee-for-service Medicaid
- Medicaid managed care plans
- CHIP
- Dual-eligible special needs plans (with Medicare)
Credentialing and enrollment
Providers enroll with the state Medicaid agency first, then credential separately with each Medicaid MCO they want to see patients from. States revalidate Medicaid enrollment at least every 5 years.
Prepare
Licenses, NPI, CAQH and group details checked and updated.
Apply
Application submitted for each provider and location.
Follow up
Status checked every 1 to 2 weeks until approval.
Confirm
Effective date and participation confirmed before billing.
Claims, eligibility and portals
Fee-for-service claims go to the state’s claims system, and managed care claims go to each MCO. Medicaid eligibility can change month to month, so we verify coverage and the assigned MCO before every visit.
Denials we prevent with Medicaid
- Patient assigned to a different MCO than billed
- Provider enrolled with the state but not credentialed with the MCO
- Services needing state-specific prior authorization
- Filing limits that differ by state and plan
- Medicaid billed before other insurance as payer of last resort
Questions about Medicaid
Is Medicaid enrollment the same as joining a Medicaid plan?
No. You enroll with the state, then credential with each managed care plan separately.
Do you bill Medicaid in every state?
Yes. We bill Medicaid fee-for-service and managed care plans across all states, following each state’s rules.
Other payers and related services
Trademarks belong to their owners. MedAi Billing Solutions is an independent billing company, not affiliated with any payer or government agency.
Get help with Medicaid claims
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.