Kentucky
Medical Billing Services in Kentucky
Outsourced billing for Kentucky practices at 4-8% of collections, plus credentialing, with no long-term contract. Kentucky Medicaid plans, substance use treatment, Medicare and commercial billing statewide.
Key takeaways
- 01Kentucky Medicaid runs through five managed care plans: Aetna Better Health, Humana Healthy Horizons, Passport Health Plan by Molina Healthcare, UnitedHealthcare and WellCare of Kentucky.
- 02Substance use treatment is billed under Kentucky's substance use disorder 1115 demonstration, with placement documented to the ASAM Criteria.
- 03Kentucky law requires insurers to pay a clean claim within 30 days (KRS 304.17A-702).
Why Practices in Kentucky Work With Medtransic
Kentucky Payer Billing
Billing for Kentucky Medicaid and Kentucky's commercial payers, under each payer's own rules
Coders Matched to Your Specialty
We put coders on your claims who already bill for practices like yours
Dedicated Account Manager
Questions about a claim go to the same person each time
No Long-Term Contract
We are paid 4-8% of collections, and there is no long-term contract to get out of
What Practices in Kentucky Value in Our Service
Kentucky Medicaid Billing. Billing for all five Kentucky Medicaid plans, including Passport Health Plan by Molina Healthcare
HIPAA Compliant. Your patient data stays HIPAA compliant, and a dedicated account manager handles your questions
See How Much Revenue Your Kentucky Practice Is Leaving on the Table
Get a free, no-obligation practice assessment. We'll analyze your claims, denials, and A/R to show you exactly where you're losing money.
Serving Practices Across Kentucky Statewide
Louisville & Jefferson County
Louisville is Kentucky's largest city and home to Norton Healthcare, Baptist Health Louisville and UofL Health (University of Louisville). Healthcare, logistics, bourbon and manufacturing employers produce a broad mix of employer plans, Medicaid managed care and Medicare.
Large Louisville employers often self-fund their health plans, which puts those claims under federal rules rather than Kentucky's.
Cardiology / oncology / orthopedics / pulmonology / behavioral health
Lexington & Bluegrass Region
Lexington is home to UK HealthCare (University of Kentucky) and CHI Saint Joseph Health, serving a community built around state government, the university and the equestrian industry.
The university community brings student health, sports medicine and behavioral health claims.
Oncology / orthopedics / sports medicine / primary care / psychiatry
Eastern Kentucky: Appalachian Region
Eastern Kentucky's Appalachian communities have high rates of diabetes, COPD, heart disease and opioid use disorder. ARH (Appalachian Regional Healthcare) and Pikeville Medical Center serve a largely Medicaid population, and many practices bill as rural health clinics.
Substance use disorder treatment, medication-assisted treatment and behavioral health make up a large share of claims in the region.
Family medicine / behavioral health / pulmonology / cardiology / rural health
Common Questions About Insurance Billing in Kentucky
Kentucky Medicaid runs through five plans: Aetna Better Health, Humana Healthy Horizons, Passport Health Plan by Molina Healthcare, UnitedHealthcare and WellCare of Kentucky. Passport Health Plan is now run by Molina Healthcare. Each plan has its own portal, authorization rules and credentialing.
Kentucky Medicaid covers substance use treatment under its substance use disorder 1115 demonstration and uses the ASAM Criteria for placement. Documentation has to support the level of care billed, from outpatient through residential, and commercial plans must cover treatment under mental health parity law.
KRS 304.17A-702 requires insurers to pay a clean claim within 30 days, and late payments carry interest under the same chapter. Self-funded employer plans, common among large Louisville employers, fall under federal law (ERISA) instead.
The federal No Surprises Act, in effect since January 2022, bars balance billing for most emergency care and for out-of-network care at in-network facilities. Northern Kentucky practices also see patients on Ohio-regulated plans, which fall under Ohio's surprise billing law (HB 388).
For Medicare, the limit is 12 months after the date of service, set by 42 CFR 424.44. Deadlines for commercial plans and Medicaid health plans come from each provider contract, and they differ from plan to plan.
Full-Service Billing for Kentucky Medical Groups
From eligibility checks to final payment, we handle your billing so you can focus on patients.
Claims Management. Claim submission and follow-up until each claim is paid or closed
Denial Management. Denied claims worked and appealed
Patient Billing. Clear patient statements and payment plans
Credentialing. Payer enrollment at $150 per application, per provider, usually 60 to 90 days with each payer, in our experience
Want a Second Look at Your Billing?
Get a free, no-obligation review of your practice's billing.
- Where claims are being denied, and why
- Which unpaid claims can still be recovered
- What billing would cost at 4-8% of collections
Specialties We Support Across Kentucky
Behavioral health and therapy are our specialty, and we also handle billing for other Kentucky practices.
- Psychology
- Behavioral Health
- Occupational Therapy
- Physical Therapy
- Mental Health
- ABA Therapy
- Psychiatry
- Speech Therapy
- Substance Use Treatment
- Primary Care
- Internal Medicine
- Pain Management
- Cardiology
Join Kentucky Practices That Get Paid Faster
Let us handle your medical billing so you can focus on patient care