Medical billing services in West Virginia
Billing, coding, credentialing and A/R follow-up for providers in West Virginia.
Billing in West Virginia: what is different
Mountain Health Trust managed care plans serve most West Virginia Medicaid members.
Key payers and contractors in West Virginia
- Medicare Part A/B
- Palmetto GBA, Jurisdiction JMPortal: Palmetto GBA eServices
- Medicare DME
- CGS, DME MAC Jurisdiction CDME supplier claims only · Portal: myCGS
- Medicaid
- West Virginia Medicaid (Mountain Health Trust)
- Blue Cross Blue Shield
- Highmark Blue Cross Blue Shield West Virginia
- 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 West Virginia providers
- Medicaid enrollment with the state, then credentialing with each managed care plan you need
- Medicare enrollment through PECOS and claims with Palmetto GBA through Palmetto GBA eServices
- 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 West Virginia: common questions
Do you bill West Virginia Medicaid and its managed care plans?
Yes. We bill West Virginia 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 West Virginia?
Medicare Part A and B claims in West Virginia are processed by Palmetto GBA (Jurisdiction JM), and we submit and track them through Palmetto GBA eServices. DME supplier claims go to a different contractor, CGS (DME MAC Jurisdiction C), through myCGS.
Can you credential new providers in West Virginia?
Yes. We handle state Medicaid enrollment, Medicare enrollment, CAQH and credentialing with the commercial and managed care plans you need in West Virginia.
Neighboring states and key payers
Get a free billing audit for your West Virginia 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.