Looking for top medical billing services in Louisiana you can count on? We work closely with all five Managed Care Organizations (MCOs), Aetna Better Health, AmeriHealth Caritas, Healthy Blue, Louisiana Healthcare Connections, and UnitedHealthcare Community Plan, and understand how to work with Healthy Louisiana Medicaid Managed Care.
Practices across New Orleans, Baton Rouge, Shreveport, and Lafayette trust our Louisiana medical billing services to handle their revenue cycle. Schedule your free billing audit and discover what your collections are missing.
To learn more about our services, please fill out the form below and we will be happy to get back to you.
Revenue Increase
Up to 35%
Collection Ratio
Billing Specialties
Empower your Louisiana practice with efficient RCM, reduced backlogs, and improved revenue performance.
The Medicaid billing process in Louisiana is complicated due to the transition of Louisiana Medicaid to Healthy Louisiana. This has resulted in five separate MCOs that each have their own provider manuals, prior authorization processes, and reimbursement rules. Additionally, the new LaHealth Connect provider portal adds another layer of complexity, as does the 180-day timely filing requirement.
Recently, we worked with a primary care clinic in Baton Rouge that had $240,000 in A/R (accounts receivable) that was over 90 days old. Their previous billing staff was submitting claims to the incorrect MCOs due to their lack of verification of Healthy Louisiana enrollee changes. As a result of patients changing plans throughout the year, this clinic was still billing the old MCOs.
In just over 45 days, we were able to assist them with cleaning up their A/R, automating their eligibility verification process, and reducing their claim denial rate from 18% to under 4%.
That is the difference between generic billing services and a team that actually understands Louisiana medical billing services requirements. Our practice management specialists have learned that specific modifiers, document requirements, and how to properly link procedures to diagnoses for Healthy Louisiana MCOs differ from what national billing companies would typically do.
Need specialized support? Our medical billing and practice management team handles appeals for Healthy Louisiana MCO denials, Medicaid Program Integrity Unit audits, and complex adjustment recoupments that Louisiana payers prefer to use.
Louisiana providers across specialties face documentation-intensive prior authorization and compliance requirements that leave little room for error. When submission standards are not met across Healthy Louisiana MCOs, denial rates climb, and A/R follows.
Medical billing services provide the needed information and support at the workflow level so that Louisiana medical practices can follow standard procedures for billing. Specifically, they can help create payer-specific documentation templates, develop appropriate protocols for prior authorizations (PAs), and help the practice understand what each of the Healthy Louisiana plans will require to ensure the lowest denial rates possible: from denial rates being in the high 20’s down to the low single digits.
Healthy Louisiana MCOs use many obscure reason codes, partial payment adjustments, and retroactive eligibility changes that would be challenging for any automated system to interpret; therefore, every exception to our system parsing 835 remittance advices will be reviewed manually by our practice management specialists. If something slips through our automated systems, we’ll help you identify that item.
We also handle the “Monday Morning Crunch” when that pile of weekend ERAs hits, and your in-house team would be pulling front-desk staff to do data entry. We process the volume so your team can focus on patient intake and care coordination.
The average client sees 40% reduction in A/R days within 60 days
Our medical billing and coding services in Louisiana are customized to meet the unique needs of healthcare providers across a wide range of specialties, ensuring efficient revenue cycle management for both small practices and large healthcare facilities.
Aetna Better Health, AmeriHealth Caritas, Healthy Blue, Louisiana Healthcare Connections, and UnitedHealthcare Community Plan—our medical billing services Louisiana team knows how each one processes claims and what triggers denials.
We grow with you. Whether you’re a solo practitioner in Lafayette or a multi-office group in New Orleans, our medical practice management services adapt to your practice’s size and needs.
We provide open and honest reporting. When you outsource medical billing services in Louisiana to us, you will always have access to real-time data, including metrics, claim status, and financial performance available through our secure dashboard.
We manage your whole revenue cycle from pre-authorization/eligibility to payment postings and chargebacks, and patient billing. We can do all of this for you as part of our Louisiana medical billing services.
Small and Independent Practices in Louisiana that rely on Full RCM Support Without the Overhead of In-House Billing Staff
Mental Health Clinics and Substance Use Treatment Centers Working Through Complex Prior Authorization Processes through Healthy Louisiana Midsize Companies.
Federally qualified health centers, treating patients in Louisiana’s underserved population and serving patients with complicated payer mixes and UDS reporting requirements.
Cardiology, orthopedics, neurology, and other specialty practices have higher-value insurance claims and complex prior authorization requirements.
There’s no need to migrate systems. Our Louisiana medical billing solutions integrate with your existing EHR and healthcare technology for a hassle-free experience.
Each week, we talk to Louisiana practice managers who are overwhelmed by Healthy Louisiana MCO denials, confusion surrounding the LaHealth Connect portal, and an increase in A/R. If this sounds familiar, let’s discuss it.
Yes, MedCare MSO bills both Louisiana workers’ compensation claims and standard health insurance claims. For workers’ compensation, we follow OWCA rules, fee schedule requirements, forms, pre-certification checks, and utilization review guidelines to help reduce denials, underpayments, and payment delays.
Louisiana covers a wide range of telehealth, but the modifier, place-of-service, and originating-site rules vary by plan and change over time. A visit that paid last quarter can deny this one if the coding hasn’t kept up. We bill to current Healthy Louisiana and commercial standards and adjust fast when a plan updates its policy.
Only after enrollment & credentialing have been completed – that’s more than one application in Louisiana. A provider must be enrolled in Medicaid in Louisiana and must be separately credentialed with each managed care plan for which they will bill. We execute those concurrently and monitor the effective dates.
We work on the denial rather than rebilling and hoping. This involves reading the remittance, determining if it is a coding, eligibility, authorization, or documentation issue, resolving the underlying cause, and appealing with records the plan wishes to have.
In Louisiana, Medicaid is the payer of last resort, meaning the commercial plan or Medicare will be paid first, and Medicaid will pay the remainder according to its rules. Billing Medicaid out of order is a denial that happens quickly and is sometimes a compliance matter. We ensure that a full coverage picture is verified in advance and the claim sequence is correct.
Ready to maximize your revenue while reducing administrative work? Let’s team up! Our medical billing expert will reach out within 12 hours.
