Medical Billing Services by State
Prospect Healthcare Solutions provides medical billing and revenue cycle support for healthcare practices across the United States. Explore our state-specific billing resources and service information below.
Explore Our Service Areas
Find state-specific medical billing information and resources tailored to healthcare practices in the markets we serve.
Texas
Medical Billing
Medical billing and revenue cycle support for healthcare practices serving patients across Texas.
New York
Medical Billing
Medical billing and revenue cycle support for healthcare practices serving patients across New York.
Connecticut
Medical Billing
Medical billing and revenue cycle support for healthcare practices serving patients across Connecticut.
Florida
Medical Billing
Medical billing and revenue cycle support for healthcare practices serving patients across Florida.
State Billing Rules at a Glance
Each state has its own Medicare contractor, Medicaid system and claim rules. These are the rules we work with for clients in each state, with the official source for each:
| State | Medicare contractor | Medicaid | Key claim rules | Source |
|---|---|---|---|---|
| New York | National Government Services (Jurisdiction K) | eMedNY for fee-for-service; most members in Medicaid managed care plans | Medicaid fee-for-service claims within 90 days of the date of service, unless a documented delay reason applies. State surprise bill law with independent dispute resolution. | eMedNY: claims over 90 days old |
| Texas | Novitas Solutions (Jurisdiction H) | TMHP for fee-for-service; STAR, STAR+PLUS, STAR Kids and STAR Health managed care | Medicaid claims must reach TMHP within 95 days of the date of service (365 days for out-of-state providers). Regulated plans pay clean claims within 30 days electronic, 45 days paper. | TMHP provider manual, section 6.1.4; TDI bulletin B-0008-05 |
| Connecticut | National Government Services (Jurisdiction K) | HUSKY Health, claims through the Connecticut Medical Assistance Program (Gainwell Technologies) | Insurers must pay interest on a complete claim not paid within 45 days of receipt (CGS 38a-816(15)). | CT Insurance Dept. bulletin HC-56 |
| Florida | First Coast Service Options (Jurisdiction N) | AHCA; most members in Statewide Medicaid Managed Care (SMMC) plans | Insurers must pay or deny within 90 days of receiving an electronic claim, or 120 days for paper (FS 627.6131). | Florida Statutes 627.6131 |
Practices in other states get the same billing service; we set up your state's payer rules during onboarding.
Nationwide Medical Billing Support
Prospect Healthcare Solutions supports healthcare practices with medical billing, coding, revenue cycle management, denial management and related services. Our location pages provide information relevant to the markets we serve.
Healthcare Practices
Across the U.S.
Medical Billing & Revenue Cycle Services
Comprehensive revenue cycle solutions for healthcare practices nationwide.
Medical Billing Services
End-to-end billing support to improve accuracy and cash flow.
Revenue Cycle Management
Comprehensive RCM solutions for a healthier revenue cycle.
Medical Coding
Accurate, specialty-specific coding support.
Denial Management
Identify, prevent and resolve claim denials.
Medical Credentialing
Provider enrollment and credentialing support.
Virtual Medical Assistant
Trained virtual assistants to support your administrative workflow.
Why Healthcare Practices Choose Prospect Healthcare Solutions
Medical Billing Expertise
Support across billing, coding, claims and reimbursement workflows.
Revenue Cycle Support
Services covering key stages of the healthcare revenue cycle.
Specialty Billing Support
Billing solutions for healthcare specialties supported by Prospect.
Nationwide Service
Remote support for eligible healthcare practices across the United States.
Need Medical Billing Support?
Speak with Prospect Healthcare Solutions about your medical billing and revenue cycle needs. Our team is here to help your practice improve efficiency and achieve a healthier financial future.
