Ohio
Medical Billing Services in Ohio
Ohio practices get billing at 4-8% of collections, credentialing on request, and no long-term contract. Ohio Medicaid, workers' compensation, Medicare and commercial insurance work for Columbus, Cleveland, Cincinnati and other communities.
Key takeaways
- 01Ohio Medicaid runs through managed care plans with separate authorization and claims workflows; check the Ohio Department of Medicaid's current plan list.
- 02Ohio Medicaid allows 365 days to file, or 180 days where coordination of benefits or eligibility delays apply (OAC 5160-1-19).
- 03Ohio requires insurers to pay clean claims within 30 days (45 if more documentation is needed), with 18% annual interest on late payments (Ohio Revised Code 3901.381 and 3901.389).
- 04Ohio Bureau of Workers' Compensation bills must be received within one year of the date of service.
Why Providers in Ohio Rely on Medtransic
Ohio Payer Billing
Ohio Medicaid and commercial claims, each sent the way that payer requires
Coders Matched to Your Specialty
We put coders on your claims who already bill for practices like yours
Dedicated Account Manager
A named contact for billing questions, reports and anything urgent
No Long-Term Contract
Our fee is 4-8% of collections, and you are not locked into a long-term contract
What Medical Groups in Ohio Count On Us For
Ohio Medicaid Billing. Billing for Ohio Medicaid managed care plans, including CareSource
HIPAA Compliant. HIPAA compliant handling of patient data, with a dedicated account manager for each practice
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Billing Support Throughout Ohio, City to City
Northeast Ohio: Cleveland & Akron
Northeast Ohio is anchored by Cleveland Clinic, University Hospitals and MetroHealth System. Cleveland Clinic draws patients from other states and countries, which brings out-of-state insurance into the mix.
Manufacturing and corporate employers provide employer-sponsored coverage, and Medicare Advantage is common.
Cardiology / orthopedics / gastroenterology / neurology / urology
Central Ohio: Columbus & Surrounding Counties
Columbus is served by OhioHealth, Nationwide Children's Hospital and The Ohio State University Wexner Medical Center. State government, education and technology employers mean many patients carry commercial coverage.
The Ohio State University Wexner Medical Center draws patients from across the state for complex care, which adds referral and prior authorization work for surrounding practices.
Primary care / pediatrics / oncology / psychiatry / sports medicine
Southwest Ohio: Cincinnati & Dayton
Southwest Ohio's healthcare market spans two metro areas, anchored by UC Health, TriHealth and Kettering Health in Dayton. The tri-state border with Kentucky and Indiana means practices often bill out-of-state Medicaid and enroll with payers in more than one state.
Cincinnati Children's Hospital Medical Center brings pediatric subspecialty referrals to the region.
Pediatrics / family medicine / orthopedics / pulmonology / dermatology
What Practices Ask About Billing Services in Ohio
Ohio Medicaid runs through several managed care plans, each with its own authorization requirements, fee schedule and claims portal. The plan line-up is set by the Ohio Department of Medicaid, so check its current list before you credential.
The No Surprises Act, a federal law in force since January 2022, protects Ohio patients from most surprise out-of-network bills. Balance billing is barred for most emergency care and for out-of-network care at in-network facilities. Ohio also has its own surprise billing law (HB 388).
Ohio Revised Code 3901.381 requires insurers to pay clean claims within 30 days, or 45 days if they need more documentation. Late payments carry 18% annual interest under 3901.389.
Ohio Medicaid allows 365 days from the date of service, or 180 days for coordination of benefits and eligibility delays. Ohio BWC bills must be received within one year of the date of service. Medicare gives one year from the date of service to file, under 42 CFR 424.44.
Ohio runs workers' compensation through a single state fund, the Ohio Bureau of Workers' Compensation, so providers bill BWC under the state fee schedule rather than a private insurer. Bills must be received within one year of the date of service, and disputes are heard by the Industrial Commission of Ohio.
Medical Mutual of Ohio is a Cleveland-based commercial insurer with its own network, prior authorization rules and payment rules, separate from the national carriers. Practices that bill it alongside Anthem, Aetna and UnitedHealthcare need each payer's rules applied separately.
The Billing We Run for Ohio Practices, End to End
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?
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- 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 Ohio
The nine practice types at the top of this list are our specialty. The rest we bill for as well.
- Behavioral Health
- Speech Therapy
- Substance Use Treatment
- Psychology
- Mental Health
- ABA Therapy
- Occupational Therapy
- Psychiatry
- Physical Therapy
- Pediatrics
- Cardiology
- Oncology
- Primary Care
Bring Medtransic to Ohio and Stop Chasing Claims
Let us handle your medical billing so you can focus on patient care