Medical Billing Services Kentucky Revenue-Focused Billing Support

Kentucky’s landscape is unique because of the heavy reliance on Managed Care Organizations (MCOs) like Passport, WellCare, and Humana Healthy Horizons. Unlike generic billers, our team specializes in the distinct prior authorization lists and portal requirements for each KY MCO, ensuring you don't lose revenue to "network confusion" or administrative denials.

Yes. We are experts in the specific billing methodologies required for Kentucky’s RHCs and Federally Qualified Health Centers. We ensure your "All-Inclusive Rate" (AIR) claims are submitted correctly on UB-04 forms and that you are receiving the full wrap-around payments you are entitled to under state law.

Absolutely. Credentialing bottlenecks are a major cash flow killer in Kentucky. We take over the entire enrollment process using the Kentucky Medicaid Partner Portal (KY MPPA) and CAQH. We track your applications weekly to ensure you get participating status with Passport, Anthem, and UnitedHealthcare as fast as possible.

We vigorously monitor bulletins from the Kentucky Department for Medicaid Services (DMS) and the Cabinet for Health and Family Services. When the state updates a fee schedule or changes a billing code, we update your rules engine immediately—often before the official notice even hits your desk.

Kentucky MCOs have strict timely filing windows that can be as short as 90 days for certain plans. We implement a "First-Pass" protocol that ensures 98% of your claims are clean and submitted within 48 hours of the encounter, virtually eliminating write-offs caused by missed deadlines.

Yes. We provide granular reports that break down your revenue by payer (e.g., Aetna Better Health vs. Traditional Medicaid). This allows us to spot if a specific MCO is systematically underpaying on certain codes compared to their contract, giving you the data you need to push back.

Yes, we support many Behavioral Health Services Organizations (BHSOs) across the Commonwealth. Our coders understand the Tier I, II, and III nuances and the specific place-of-service codes required by Kentucky Medicaid to prevent audits and recoupments.

We work with all major EHR platforms and ensure our workflows support your connectivity with the Kentucky Health Information Exchange (KHIE). You do not need to change your software; we integrate directly into your existing practice management system to keep operations smooth.

We treat your patients as if they were our own. Our US-based support team explains complicated EOBs and deductibles in plain English. We help set up compassionate payment plans that respect your patient relationships while ensuring you get paid what you are owed.

We can typically launch within 15-30 days. We start with a comprehensive "Health Check" of your current A/R to identify immediate recovery opportunities. Then, we configure your EDI connections with Kentucky payers and take over the heavy lifting, so you see no disruption in cash flow.