Billing for Services: Key Considerations for Providers

Your organization may be required to change billing practices upon contracting, or entering into an agreement, with a health plan. Submitting a formal medical billing claim form may be a new experience for your organization. Your organization may be used to sending invoices directly to the state or a county agency for long-term services and supports (LTSS) you provided to Medicaid enrollees. While billing practices and requirements will vary between health plans, there is some basic information that will be common across all plans. This brief outlines key issues for LTSS providers to consider when billing or submitting claims to health plans.

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