Medical billing services in Washington
Billing, coding, credentialing and A/R follow-up for providers in Washington.
Billing in Washington: what is different
Apple Health integrated managed care plans cover physical and behavioral health for most members.
Key payers and contractors in Washington
- Medicare Part A/B
- Noridian Healthcare Solutions, Jurisdiction JFPortal: Noridian Medicare Portal (NMP)
- Medicare DME
- Noridian, DME MAC Jurisdiction DDME supplier claims only · Portal: Noridian Medicare Portal (NMP)
- Medicaid
- Apple Health (Washington Medicaid)Portal: ProviderOne
- Blue Cross Blue Shield
- Premera Blue Cross and Regence 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 providers
- Medicaid enrollment with the state, then credentialing with each managed care plan you need
- Medicare enrollment through PECOS and claims with Noridian Healthcare Solutions through the Noridian Medicare Portal (NMP)
- 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: common questions
Do you bill Apple Health and its managed care plans?
Yes. We bill Apple Health 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?
Medicare Part A and B claims in Washington are processed by Noridian Healthcare Solutions (Jurisdiction JF), and we submit and track them through the Noridian Medicare Portal (NMP). DME supplier claims go to a different contractor, Noridian (DME MAC Jurisdiction D), through the Noridian Medicare Portal (NMP).
Can you credential new providers in Washington?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in Washington.
Neighboring states and key payers
Get a free billing audit for your Washington 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.