Diamond State Health Plan
Delaware Medicaid members in managed care are in the Diamond State Health Plan, under the Division of Medicaid and Medical Assistance. The plan is the payer. A Pennsylvania HealthChoices plan will not pay a Delaware member.
Medical Billing Services in Delaware
Delaware Medicaid is small, and it is not Pennsylvania Medical Assistance. Delaware Medicaid members in managed care are in the Diamond State Health Plan, under the Division of Medicaid and Medical Assistance. The plan is the payer. A Pennsylvania HealthChoices plan will not pay a Delaware member.
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What a claim follows in Delaware
Delaware Medicaid is small, and it is not Pennsylvania Medical Assistance.
Novitas, Jurisdiction L
Medicare Part A and Part B for a Delaware practice go to Novitas Solutions, Jurisdiction L, the same contractor as Pennsylvania, New Jersey, and Maryland. That shared contractor does not merge the Medicaid programs.
Workers' compensation
Delaware is not a no-fault state. A work injury is billed to the employer's carrier under the Industrial Accident Board. It is not a Diamond State Health Plan claim.
Delaware sits between three larger Medicaid programs. The claim still uses Delaware enrollment. Medicare can go to the same Novitas mailbox as a Philadelphia claim. Medicaid cannot.
Nearby states
Delaware billing questions
What is Delaware's Medicaid managed care called?
The Diamond State Health Plan, under the Division of Medicaid and Medical Assistance.
Where does a Delaware Medicare claim go?
Novitas Solutions, Jurisdiction L, the same contractor as Pennsylvania, New Jersey, and Maryland.
Does a Delaware practice change the fee?
The fee is a percentage of net collections. The written rate follows volume, specialty, and how much of the cycle you hand over. There is no setup fee, and the agreement is month to month. The state is not a surcharge. How pricing is set.