Vermont
Medical Billing Services in Vermont
Medtransic bills insurance for Vermont practices for 4-8% of collections and handles credentialing, with no long-term contract. Green Mountain Care, Medicare and commercial plans, billed for Burlington, Rutland and the rest of the state.
Key takeaways
- 01Vermont Medicaid is known as Green Mountain Care, and the commercial market centers on Blue Cross Blue Shield of Vermont and MVP Health Care.
- 02Vermont's claims payment law (18 V.S.A. 9418) requires timely payment and 12% annual interest on late claims.
- 03Upper Valley practices regularly bill both Vermont and New Hampshire plans because patients cross the Connecticut River for care.
Why Medical Groups in Vermont Switch to Medtransic
Vermont Payer Billing
We bill Green Mountain Care as well as the commercial insurers common in Vermont
Coders Matched to Your Specialty
Your coder is matched to your specialty, whether that is therapy, psychiatry or another field
Dedicated Account Manager
Questions about a claim go to the same person each time
No Long-Term Contract
Billing at 4-8% of collections, with no long-term contract
What Physicians in Vermont See in Our Results
Vermont Medicaid Billing. Billing for Green Mountain Care and Vermont's commercial payers
HIPAA Compliant. Medtransic is HIPAA compliant, and every practice gets a dedicated account manager
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Coverage Across Vermont and Beyond
Burlington & Chittenden County
Burlington is Vermont's largest city and main healthcare hub, home to the University of Vermont Medical Center, the state's academic medical center. Technology employers and the university mean many patients carry commercial coverage.
Blue Cross Blue Shield of Vermont plans are part of everyday billing for Burlington practices.
Cardiology / oncology / orthopedics / psychiatry / primary care
Rural Vermont: Rutland, Barre & Northeast Kingdom
Vermont's rural communities are served by Rutland Regional Medical Center, Central Vermont Medical Center (UVM Health Network) and North Country Hospital in Newport. The Northeast Kingdom is very rural, so telehealth and rural health clinic billing matter.
Vermont has a long history of payment reform, so practices need to keep up with state changes to Medicaid and commercial payment rules.
Family medicine / internal medicine / behavioral health / rural health / geriatrics
Upper Valley & Upper Connecticut River Valley
The Upper Valley straddles the Vermont-New Hampshire border, with Dartmouth Hitchcock Medical Center in Lebanon, NH, as the main referral center for both states. Vermont providers in Windsor and Orange counties regularly refer patients across the river.
Upper Valley practices need enrollment with both Vermont and New Hampshire commercial payers and Medicaid programs.
Primary care / family medicine / behavioral health / internal medicine / geriatrics
Answers on Working With Us in Vermont
Vermont Medicaid, known as Green Mountain Care, is billed to the state under its own rules and fee schedule. Long-term services and home- and community-based services have their own authorization and billing requirements.
Vermont's claims payment law, 18 V.S.A. 9418, requires insurers to pay claims on time and charges 12% annual interest on late claims. Self-funded employer plans fall under federal law (ERISA) instead.
The No Surprises Act, a federal law in force since January 2022, protects Vermont 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.
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. Upper Valley practices billing New Hampshire plans should check those plans' deadlines too.
Managed Billing for Vermont Physicians
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 Vermont
Our core work is mental health, behavioral health and therapy. Other Vermont specialties are billed too.
- Psychology
- Substance Use Treatment
- Occupational Therapy
- Speech Therapy
- ABA Therapy
- Mental Health
- Behavioral Health
- Psychiatry
- Physical Therapy
- Primary Care
- Internal Medicine
Put Medtransic to Work in Vermont Today
Let us handle your medical billing so you can focus on patient care