Out-of-State Medicaid Billing, Commercial Insurance Billing and Denial Follow-up Services

The Vendor is required to provide out-of-state Medicaid billing services and commercial insurance billing and denial follow-up services on behalf of county healthcare facilities.
- Out-of-state Medicaid billing services
• Claim submission and processing
• Eligibility verification and enrollment
• Provider enrollment
- Commercial insurance billing and denial follow-up services
• Billing, claim submission, and resubmission
• Appeals processing
• Claim resubmission and correction
• Payer communication and issue resolution
• Denial and billing trend reporting.