Medical billing services in Maryland
Billing, coding, credentialing and A/R follow-up for providers in Maryland.
Billing in Maryland: what is different
Maryland Medicaid behavioral health is carved out to a separate administrative services organization.
Key payers and contractors in Maryland
- Medicare Part A/B
- Novitas Solutions, Jurisdiction JLPortal: Novitasphere
- Medicare DME
- Noridian, DME MAC Jurisdiction ADME supplier claims only · Portal: Noridian Medicare Portal (NMP)
- Medicaid
- Maryland Medicaid (HealthChoice)Portal: eMedicaid
- Blue Cross Blue Shield
- CareFirst BlueCross BlueShield
- Medicare Advantage
- UnitedHealthcare, Humana, Aetna, Wellcare, Blue plans and others, depending on the county
Contractor assignments and plan lists change. We confirm the current setup for your practice during onboarding.
How we work with Maryland providers
- Medicaid enrollment with the state, then credentialing with each managed care plan you need
- Medicare enrollment through PECOS and claims with Novitas Solutions through Novitasphere
- Credentialing and contracting with commercial and Blue plans
- Eligibility checks that confirm each patient’s plan and assigned MCO before the visit
- Prior authorization tracking by plan
- Denial, appeal and A/R follow-up under each payer’s filing limits
Medical billing in Maryland: common questions
Do you bill Maryland Medicaid and its managed care plans?
Yes. We bill Maryland Medicaid fee-for-service claims and each Medicaid managed care plan, after confirming the patient’s assigned plan for the date of service.
Who processes Medicare claims in Maryland?
Medicare Part A and B claims in Maryland are processed by Novitas Solutions (Jurisdiction JL), and we submit and track them through Novitasphere. DME supplier claims go to a different contractor, Noridian (DME MAC Jurisdiction A), through the Noridian Medicare Portal (NMP).
Can you credential new providers in Maryland?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in Maryland.
Neighboring states and key payers
Get a free billing audit for your Maryland practice
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.