Washington, D.C.
Medical Billing Services in Washington, D.C.
Washington, D.C. practices get billing at 4-8% of collections, credentialing on request, and no long-term contract. FEHB, DC Medicaid, Medicare and commercial billing across the District.
Key takeaways
- 01DC Medicaid will not pay a claim submitted more than 365 days after the date of service, and Medicare crossovers get 180 days from the Medicare disposition (29 DCMR 900).
- 02DC Medicaid managed care runs through AmeriHealth Caritas DC and MedStar Family Choice DC, with HSCSN serving children with special needs.
- 03Since January 2026, some adults who lost DC Medicaid are covered by the Healthy DC Plan, so verify which program a patient is in.
- 04As the seat of the federal government, DC has many patients covered by Federal Employees Health Benefits (FEHB) plans.
How Providers in Washington, D.C. Switch to Medtransic
Washington, D.C. Payer Billing
Washington, D.C. payers, public and private, from DC Medicaid to employer plans
Coders Matched to Your Specialty
A therapy practice gets coders who know therapy, and the same goes for psychiatry or ABA
Dedicated Account Manager
Your account has one owner on our side, from the first week onward
No Long-Term Contract
A fee of 4-8% of collections, and no long-term contract holding you in
Why Billing Managers in Washington, D.C. See in Our Results
DC Medicaid and FEHB Billing. Billing for AmeriHealth Caritas DC, MedStar Family Choice DC and Federal Employees Health Benefits plans
HIPAA Compliant. A HIPAA compliant team, and a dedicated account manager who knows your practice
See How Much Revenue Your Washington, D.C. Practice Is Leaving on the Table
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Billing Help Throughout Washington, D.C. and Beyond
Federal & Academic Medical Core
The District's academic medical centers, MedStar Georgetown University Hospital, George Washington University Hospital and MedStar Washington Hospital Center, draw DC residents and referral patients from Maryland and Virginia. Many patients carry FEHB coverage.
FEHB offers many plan options from national and local carriers, each with its own authorization rules and payment rates.
Internal medicine / cardiology / oncology / neurology / psychiatry
Community Health & Pediatric Care
Howard University Hospital and Children's National Hospital anchor community and pediatric care, serving many Medicaid patients across the District, including east of the Anacostia River. Sibley Memorial Hospital, part of Johns Hopkins Medicine, adds another academic-affiliated system.
DC Medicaid managed care runs through AmeriHealth Caritas DC and MedStar Family Choice DC, with Health Services for Children with Special Needs (HSCSN) serving children with special needs.
Pediatrics / primary care / OB/GYN / behavioral health / family medicine
Common Questions on Working With Us in Washington, D.C.
The DC Department of Health Care Finance contracts with AmeriHealth Caritas DC and MedStar Family Choice DC for DC Healthy Families, and Health Services for Children with Special Needs (HSCSN) serves children with special needs. Each plan has its own authorization requirements and claims process.
Since January 2026, some adults who left DC Medicaid are covered by the Healthy DC Plan, offered through AmeriHealth, MedStar or CareFirst. It changes eligibility checks, so confirm whether a patient is on DC Medicaid or the Healthy DC Plan before billing.
FEHB offers many plan options, such as the Blue Cross Blue Shield Federal Employee Program, Aetna and GEHA, each with its own authorization rules and payment rates. FEHB plans generally require claims by 31 December of the year after the service.
DC patients are protected by the federal No Surprises Act, in effect since January 2022. It bars balance billing for most emergency care and for out-of-network care at in-network facilities.
DC Medicaid allows 365 days from the date of service, and 180 days for Medicare crossovers. A Medicare claim filed more than 12 months after the service date is denied (42 CFR 424.44). Commercial plans set their own limits in their contracts.
Everything We Manage for Washington, D.C. 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?
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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 Washington, D.C.
The nine practice types at the top of this list are our specialty. The rest we bill for as well.
- Substance Use Treatment
- Psychiatry
- Mental Health
- Psychology
- Speech Therapy
- Physical Therapy
- Behavioral Health
- ABA Therapy
- Occupational Therapy
- Primary Care
- Cardiology
- Oncology
- Pediatrics
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