Medical billing services in Washington, DC
Billing, coding, credentialing and A/R follow-up for providers in Washington, DC.
Billing in Washington, DC: what is different
DC has a large federal workforce, so Federal Employee Program claims are common.
Key payers and contractors in Washington, DC
- 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
- DC Medicaid
- 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 Washington, DC 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 Washington, DC: common questions
Do you bill DC Medicaid and its managed care plans?
Yes. We bill DC 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 Washington, DC?
Medicare Part A and B claims in Washington, DC 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 Washington, DC?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in Washington, DC.
Neighboring states and key payers
Get a free billing audit for your Washington, DC 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.