Locations
A billing company that bills every state the same way is a liability. We do the opposite.
Most billing companies process claims the same way regardless of where you practice. The payer denying your claim in one state operates under different rules than the one denying it in another, and state Medicaid programs are never interchangeable. The process behind your revenue cycle needs to account for that.
MedHeave manages the full revenue cycle for practices across the US with teams that understand how payers in your state operate, not just the codes you submit.
Most billing companies know billing.
Few know the state you practice in.
Payer rules, Medicaid programs, filing deadlines and coverage requirements shift depending on where you practice. What works in one state does not always work in another, and a billing partner that has not taken the time to understand that difference will quietly cost you more than any single denial ever will.
MedHeave works with medical practices across the US as a dedicated revenue cycle department, not an outsourced service. The people managing your billing know the payer environment you operate in every day. They take ownership of the full revenue cycle from charge entry to final payment, so you are never left wondering why a claim did not come back the way it should have.
By the time you realize your billing company does not know your state, months of AR are already aging past recovery.
The billing gaps that come from not knowing your state do not show up as dramatic failures. They show up as denials with no clear pattern, AR that keeps aging and a collection rate that never fully reflects what your practice earned.
Your Medicaid program has rules that most billing companies never learn
Every state administers its own Medicaid program with its own fee schedules, covered services, prior authorization requirements, and claim submission rules. MassHealth processes claims differently from Texas Medicaid, and a billing company that applies the same workflow to both will keep generating the same denials without ever understanding what is causing them.
Workers' compensation billing changes by state
Workers’ compensation billing is governed by state-specific fee schedules, filing deadlines and adjuster protocols that vary significantly across state lines. A billing company unfamiliar with how comp claims work in your state will miss filing windows, apply the wrong fee schedule and generate denials that require state-specific knowledge to resolve.
Commercial payers behave differently in different markets
The same commercial payer operates differently depending on the state. Authorization thresholds, timely filing limits, fee schedules, covered service lists and documentation requirements all vary by market. A billing company managing your claims without that market-level knowledge will submit against the wrong requirements and treat the denials that come back as standard rather than preventable.
Medicare rules change depending on your MAC jurisdiction
Medicare is federal, but it does not run the same way everywhere. Each MAC sets its own prior authorization requirements, LCDs, and documentation standards. California alone has two MAC jurisdictions. Which one your practice falls under directly affects how your claims need to be submitted.
Unfamiliarity with rules will affect your deadlines
Timely filing limits are not the same across every payer and every state. A commercial payer in one state may allow 90 days from the date of service while another allows 180. Missing that window because the billing company applied the wrong deadline means the claim cannot be recovered regardless of how clean it was.
Yes, we work in your state.
No, we did not just Google the payer rules.
The states on this map are not just locations we service. They are markets we have spent years learning, billing in and building processes around.
Our services
Every part of your revenue cycle managed by a team that knows your state's payer rules.
Every service listed below is managed with the state-specific payer knowledge your revenue cycle requires. Each one is part of a single connected operation where every stage has a clear owner and every claim has a path to payment.
Revenue cycle management
We oversee your entire revenue cycle from patient registration to final payment, connecting every touchpoint so nothing is missed, delayed, or left uncollected.
Medical billing
We manage your entire billing cycle from charge entry to payment posting, reducing errors and submission delays that cost practices like yours thousands in avoidable rework each month.
Medical coding
Accurate coding is the foundation of a clean claim. Our AAPC-certified coders apply the right codes the first time, protecting your reimbursement rate and reducing audit exposure.
Medical credentialing
We manage your entire credentialing cycle, from primary source verification to CAQH maintenance and PECOS enrollment, so you can bill without interruption across every payer.
Prior authorization
We handle all prior auth requests, follow-ups, and peer-to-peer coordination so your team is not spending hours on hold waiting for approvals.
Denial management
We review, appeal, and resolve denied claims while identifying the root patterns causing them, so the same denial does not show up on next month's report.
Worker's comp & no-fault billing
We manage state-specific regulations, lien-based billing for personal injury, IME denial responses, and Explanation of Review disputes.
Patient billing
We manage the full collection process, from good faith estimates to balance billing disputes, recovering what is owed without damaging your patient relationship.
Our specialties
Specialties we bill for across every state
we operate in.
The coding logic may be consistent across states but authorization requirements, fee schedules and payer behavior shift depending on where the practice operates. Every specialty listed below is managed by people who know the specialty and the market it bills in.
Behavioral health
In behavioral health, missing eligibility or session tracking can cost several visits, not just one. We stay ahead of authorization limits, benefit caps, telehealth changes, and co-pay structures so billing stays steady through care.
Podiatry
For podiatry billing, we make sure modifiers like 25 and RT/LT are accurate, services align with global periods and payer edits, and orthotics always meet payer-specific authorization and DME requirements before claims go out.
Urgent care
We handle urgent care billing across walk-ins, diagnostics, and procedures. From there, we track payer coding rules, facility contracts, authorizations, and eligibility checks so claims never get delayed or denied.
Orthopedic
We handle orthopedic billing, making sure procedures are authorized upfront, modifiers like LT/RT and bilateral are applied correctly, and surgical cases with implants are coded and billed to payer requirements for accurate reimbursement.
Cardiology
Cardiology billing often triggers NCCI edit denials, bundling issues, and global period violations when E/M services and procedures are billed together. We manage coding and modifier logic to reduce denials and boost payments.
DME
DME billing is handled by aligning orders, documentation, and delivery timelines with payer rules. We apply HCPCS coding, manage capped rentals, and enforce refill limits so claims are never denied for documentation paperwork.
Pediatrics
In pediatrics, we handle well visits and immunizations, making sure vaccine administration and VFC eligibility are correct, age-based coding stays accurate as well, so nothing gets missed, underbilled, or delayed at any visit.
Anesthesia
The accuracy of anesthesia billing depends on capturing start and stop times correctly. We ensure accurate time capture, apply base units and modifiers, and handle medical direction and concurrency so every unit is billed right.
Don’t see your specialty? We probably work in it.
Built for practices that need billing aligned with their specialty and their state's payer rules.
From single specialty practices to hospital systems, the common thread is the same. Operating in a state with its own payer rules, Medicaid programs and filing requirements while managing high claim volumes across multiple providers and service lines.
Specialty practices
We manage billing cycles of practices with multiple specialties where differences in coding, documentation and payer expectations across state lines can lead to uneven billing outcomes if not managed consistently.
Primary care groups
We work with primary care groups where high patient volume combined with state-specific payer rules and Medicaid requirements means a single billing gap can affect hundreds of claims before anyone catches it.
Emergency departments
We work with emergency care settings where incomplete intake information, high denial rates and state-specific billing regulations require structured workflows and consistent corrective action to keep revenue moving.
Hospital systems
We support hospital systems managing both facility and professional billing across multiple states, where alignment between departments and state-specific payer rules determines how consistently reimbursement arrives.
Multi-specialty practices
Multi-specialty practices require billing workflows that can handle different coding standards, payer rules, and documentation requirements across departments. From podiatry to oncology, our specialty-focused billers and coders manage RCM across every service line accurately.
FAQs
No matter the ZIP code, the questions we hear are surprisingly consistent.
We have heard these questions before.
Every practice that works with MedHeave had reservations before they started. These are the questions they asked and the answers that helped them move forward.
Do you understand how payers operate in my state?
Every state has its own Medicaid program, workers’ compensation regulations and commercial payer behavior. We manage billing across multiple states and build our workflows around the specific payer rules, filing deadlines and authorization requirements that apply where you practice.
What happens to our existing claims when we switch to MedHeave?
We start with a full audit of your current AR, identify every claim still within its rework window and prioritize accordingly. Commercial payers allow approximately 90 days and Medicare allows up to a year. Nothing gets written off without your approval.
How quickly do you submit claims after a patient encounter?
Within 24 hours of a signed encounter note. If documentation is incomplete or unsigned we flag it to the provider the same day so nothing sits waiting.
What does the free audit actually cover?
We review your payer mix, denial patterns, AR aging, credentialing status and coding accuracy before we touch anything. You get a complete picture of where your revenue cycle is falling short before any commitment is made.
Who manages our account and what happens if they leave?
Every practice has two dedicated account managers who know the account inside out. Every process runs under documented SOPs with supervisor oversight so a staffing change on our end never affects your billing.
How is MedHeave different from our current billing company?
Most billing companies process claims. MedHeave takes ownership of the full revenue cycle as a dedicated department, with state-specific payer knowledge, 72 hour denial action and percentage based pricing tied directly to what your practice collects.
Your practice is good at what it does.
Shame if your billing wasn't.
We have worked with enough practices to know that most of them are leaving money on the table without realizing it. Book a free audit and we will show you exactly where yours is going.
