Medical billing for Pennsylvania practices

Medical Billing Services in Pennsylvania

HealthChoices is not Maryland HealthChoice, and it is not New York Medicaid. The Department of Human Services runs Medical Assistance. Physical-health managed care is HealthChoices, and the plan follows the zone. Community HealthChoices covers long-term services for many older adults and members with disabilities. Fee-for-service Medical Assistance is a separate submission. The zone on the card decides the plan.

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What a claim follows in Pennsylvania

HealthChoices is not Maryland HealthChoice, and it is not New York Medicaid.

HealthChoices

The Department of Human Services runs Medical Assistance. Physical-health managed care is HealthChoices, and the plan follows the zone. Community HealthChoices covers long-term services for many older adults and members with disabilities. Fee-for-service Medical Assistance is a separate submission. The zone on the card decides the plan.

Novitas, Jurisdiction L

Medicare Part A and Part B for a Pennsylvania practice go to Novitas Solutions, Jurisdiction L, with New Jersey, Delaware, and Maryland. New York uses National Government Services. Ohio uses CGS. West Virginia uses Palmetto Jurisdiction M.

Auto medical benefits and workers' compensation

Pennsylvania auto policies include first-party medical benefits. That bill goes to the auto insurer, not to the health plan. A work injury goes to the employer's carrier under the Bureau of Workers' Compensation.

Pennsylvania has more than one Medicaid track. HealthChoices, Community HealthChoices, and fee-for-service Medical Assistance are not interchangeable. A Philadelphia Medicare claim can share Novitas Jurisdiction L with a New Jersey claim and still not share a Medicaid plan.

Nearby states

Pennsylvania billing questions

What is the difference between HealthChoices and Community HealthChoices?

HealthChoices is physical-health managed care. Community HealthChoices covers long-term services for many older adults and members with disabilities.

Where does a Pennsylvania Medicare claim go?

Novitas Solutions, Jurisdiction L. Ohio uses CGS. New York uses National Government Services.

Does a Pennsylvania 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.