Louisiana Medical Billing Services

Medical billing in Louisiana follows strict rules for Louisiana Medicaid (Bayou Health), Medicare, and commercial payers. Practices in New Orleans, Baton Rouge, Shreveport, Lafayette, Lake Charles, and Alexandria deal with prior authorizations, medical-necessity requirements, NCCI and Bayou Health-specific edits, and payer-specific telehealth rules.

Bayou Health operates through multiple MCOs: Aetna Better Health of Louisiana, UnitedHealthcare Community Plan, and Louisiana Healthcare Connections. Each MCO maintains its own authorization grids, documentation requirements, billing edits, fee schedules, and appeal deadlines. MZ Medical Billing tracks these updates and applies them to billing workflows for primary care providers, therapy practices, behavioral health clinics, and specialty practices. Fee-for-service Louisiana Medicaid programs, including certain waiver services, are processed via a separate workflow to avoid edit conflicts.

Telehealth billing rules vary by payer. Bayou Health requires GT for live video visits. Blue Cross Blue Shield of Louisiana uses POS 02 or POS 10 depending on patient location. Audio-only visits are accepted only by specific plans. MZ Medical Billing applies each payer’s telehealth rules at the claim level to reduce rejections tied to POS or modifier mismatches.

Claims are reviewed for eligibility, authorizations, PCP assignment, benefit limits, and CPT/ICD alignment with each payer’s policy. Our internal audits flag modifier conflicts, missing documentation, Bayou Health edit mismatches, and coding errors before submission. Denials caused by missing authorizations, coordination-of-benefits issues, payer-specific edits, or diagnosis–procedure misalignment are corrected and resubmitted within each payer’s filing window: Bayou Health MCOs (90–180 days), Louisiana Medicaid FFS (12 months), Medicare (12 months), and BCBS Louisiana (180 days).

MZ Medical Billing also handles Medicare–Bayou Health crossover claims manually when automated feeds fail and monitors payer portals, including Aetna, UnitedHealthcare Community Plan, Louisiana Healthcare Connections, BCBS Louisiana, Ambetter, Cigna, Aetna commercial, and Medicare, for claim status, appeals, and underpayment recovery.

Louisiana practices working with MZ Medical Billing achieve 95–98% claim approval rates, 94–96% first-pass resolution, and A/R averages of 27–30 days across Bayou Health MCOs, Medicare, and commercial payers.

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98%
Claim Approval Rate

97%
First pass Ratio

<30
Days in AR

96%
Collection Ratio

Outsourcing Medical Billing in Louisiana with MZ Medical Billing

Outsourcing to MZ Medical Billing gives Louisiana healthcare providers a dedicated billing team that manages the full medical billing and revenue cycle with accuracy and payer compliance. Our billers handle claim submission, payment posting, denial correction, and A/R follow-up for practices of all sizes, including solo practices, specialty groups, therapy providers, behavioral health agencies, and hospital-affiliated outpatient clinics.

Louisiana’s payer landscape includes Louisiana Medicaid (Bayou Health), the state’s MCOs (Aetna Better Health of Louisiana, UnitedHealthcare Community Plan, and Louisiana Healthcare Connections), Medicare, and major commercial payers. Outsourcing billing stabilizes revenue, reduces administrative workload, and minimizes errors tied to authorization requirements, Bayou Health documentation standards, claim-edit rules, and commercial payer policies. MZ Medical Billing provides detailed reporting, direct communication with providers, and ongoing workflow oversight, letting clinicians focus on patient care.

Louisiana Medicaid operates through fee-for-service Medicaid and Bayou Health MCOs, each with its own authorization grids, billing instructions, appeal timelines, and medical-necessity rules. Providers must comply with Bayou Health provider manuals, MCO-specific requirements, and all mandatory enrollment and credentialing obligations. Aetna, UnitedHealthcare Community Plan, and Louisiana Healthcare Connections maintain separate portals, each with unique preauthorization and claim-submission procedures.

Bayou Health and Louisiana Medicaid require electronic claim transactions through standard EDI files (837, 835, 270/271, and related formats). The Louisiana Medicaid fee schedule, Bayou Health MCO reimbursement policies, and periodic updates affect payment amounts for primary care, behavioral health, therapy, diagnostics, and specialty procedures.

Regulatory risk rises when providers miss enrollment renewals, fail to meet MCO documentation standards, or overlook authorization or claim-edit updates. MZ Medical Billing tracks payer updates, policy revisions, prior authorization changes, and fee schedule adjustments for Bayou Health, Louisiana Medicaid FFS, Medicare, and commercial payers—and applies them to billing workflows before they affect revenue.

Leading Medical Billing Company in Louisiana

MZ Medical Billing supports Louisiana providers with billing operations based on accuracy, payer compliance, and transparent reporting. We manage the full billing workflow for clinics across New Orleans, Baton Rouge, Shreveport, Lafayette, Lake Charles, Alexandria, and surrounding areas. Our processes strengthen reimbursement for primary care groups, specialty practices, behavioral health agencies, therapy clinics, RHCs, and FQHCs operating under Louisiana payer rules.

Improving Louisiana Revenue Cycles With Accurate Billing Workflows

Our Louisiana billing systems are built around precise coding, pre-submission auditing, authorization checks, and disciplined A/R follow-up. Every workflow aligns with:

Louisiana Medicaid (Bayou Health)

Louisiana Medicaid Provider Manuals
Bayou Health fee schedules
State documentation and encounter rules
Telehealth and POS/modifier requirements

Bayou Health Managed Care Organizations (MCOs)

Aetna Better Health of Louisiana
UnitedHealthcare Community Plan
Louisiana Healthcare Connections
(MCO-specific authorization lists, appeal timelines, claim-edit rules)

Commercial Payers Operating in Louisiana

Blue Cross Blue Shield of Louisiana
Ambetter
Cigna
Aetna
UnitedHealthcare

Medicare Part B Louisiana

This structure keeps claim accuracy consistent and reduces preventable denials and payment delays.

End-to-End Louisiana Medical Billing Services

Our team manages every phase of the revenue cycle, applying Louisiana payer rules at each step:

Patient registration and eligibility verification (Bayou Health + MCO portals)
ICD-10, CPT, and HCPCS coding review
Charge entry and encounter-level accuracy checks
Claim submission to Bayou Health, MCOs, Medicare, and commercial insurers
ERA posting and payment reconciliation
Denial review, correction, and resubmission
A/R follow-up and overdue claim resolution
Monthly financial and denial reporting

Each stage is aligned with Bayou Health, Louisiana Medicaid FFS, Medicare Louisiana, and commercial payer requirements.

Compliance Monitoring for Bayou Health and Commercial Plans

Louisiana Medicaid and commercial insurers issue updates on authorizations, encounter reporting, medical policies, and telehealth rules. We track all changes from:

Louisiana Medicaid (Bayou Health)

Fee schedule updates
Provider Manual revisions
Encounter-data rules
Authorization and documentation policy changes
Telehealth rules, POS requirements, and modifier standards

Bayou Health MCOs

Aetna Better Health of Louisiana
UnitedHealthcare Community Plan
Louisiana Healthcare Connections
(Authorization lists, filing deadlines, appeal procedures)

Major Commercial Networks in Louisiana

Blue Cross Blue Shield of Louisiana
Ambetter
Cigna
Aetna
UnitedHealthcare

Federal Programs

Medicare Part B Louisiana

Updates are integrated directly into workflows to prevent denials from outdated guidance.

Deep Understanding of Louisiana’s Billing and Audit Environment

Louisiana Medicaid and commercial payers require documentation that matches billed services and state policy. Providers may face:

Louisiana Medicaid & Bayou Health Reviews

Encounter-data validation
Prior-authorization checks
Service-plan and chart documentation audits
Telehealth documentation and modifier accuracy
Medical-necessity and coverage-criteria reviews

Federal-Level Audits

PERM audits for Louisiana Medicaid and CHIP
CMS TPE (Targeted Probe & Educate)
OIG post-payment reviews

Louisiana-Specific Oversight Areas

RHC and FQHC encounter guidelines
Behavioral health service-plan documentation
Therapy plan-of-care requirements
Telehealth POS and modifier compliance
Credentialing and revalidation through Louisiana Medicaid and MCO networks

Our billing systems follow these oversight standards to reduce recoupments and prevent payment disruptions.

Operational Fit for Louisiana Practices

Louisiana practices manage a diverse payer mix, including Bayou Health MCOs, Medicaid FFS, Medicare, and commercial insurers. Clinics across Louisiana must account for regional variations in MCO enrollment and differing plan penetration.

Our billing team adjusts workflows based on each clinic’s structure:

Eligibility and authorization checks tied to payer mix
Chart-to-claim documentation review for behavioral health, therapy, and primary care
Follow-up timelines matched to Louisiana payer processing cycles
Multi-site practice billing with cross-region Bayou Health MCO coverage
RHC/FQHC encounter requirements and revenue reporting
Telehealth billing aligned with Louisiana Medicaid and MCO rules

These adjustments reduce repetitive denials and maintain consistent accuracy.

High-Accuracy Billing Review Before Submission

Before claim submission, our team reviews:

ICD-10, CPT, and HCPCS coding
Bayou Health and MCO authorization rules
Commercial payer medical policies
Medicare modifier and documentation requirements
Telehealth POS and modifier accuracy for Louisiana payers

Early identification of errors improves payment reliability and reduces administrative delays for Louisiana providers.

Louisiana Medical Billing Services We Offer

MZ Medical Billing Services provides full medical billing and revenue cycle management services for healthcare providers across Louisiana. Our workflows follow Louisiana Medicaid (Bayou Health) rules, Bayou Health MCO procedures, Medicare Part B Louisiana guidelines, and the policies of commercial insurers including Blue Cross Blue Shield of Louisiana, Ambetter, UnitedHealthcare, Aetna, and Cigna. Each step is built on accurate coding, documentation alignment, payer-specific requirements, and clean claim submission so clinics across New Orleans, Baton Rouge, Shreveport, Lafayette, Lake Charles, and Alexandria maintain consistent reimbursement and reduced administrative pressure.

Our credentialed billing specialists, AAPC, AHIMA, and HBMA certified, have direct experience with Louisiana Medicaid billing rules, MCO authorization processes, Louisiana telehealth requirements, multi-site clinic billing, RHC/FQHC encounter reporting, and behavioral health documentation standards. We support hospitals, RHCs, FQHCs, specialty practices, behavioral health programs, therapy centers, and primary care clinics statewide.

Revenue Cycle Management (RCM)

We manage the full Louisiana revenue cycle including eligibility checks, charge capture, coding review, claim prep, continuous claim monitoring, payment posting, and reporting. All steps follow Louisiana Medicaid Provider Manuals, Bayou Health MCO authorization rules, Medicare Louisiana guidelines, and commercial payer policies. This structure keeps reimbursement predictable and reduces delays tied to documentation gaps or outdated payer rules.

Appeals and Disputes Management

Our appeals team prepares reconsiderations and corrected claims based on Louisiana Medicaid and Bayou Health MCO instructions. Appeals include proper coding references, clinical documentation, medical-necessity support, authorization verification, and proof of timely filing. This recovers payments denied for processing errors, documentation issues, or payer-interpretation conflicts.

Denial Management

Denials are reviewed by type to identify the cause: missing authorizations, diagnosis-procedure conflicts, modifier issues, benefit limits, encounter-level documentation gaps, or payer-rule mismatches. Each issue is corrected and incorporated into workflow updates. This improves claim accuracy across Louisiana Healthcare Connections, Aetna Better Health of Louisiana, UnitedHealthcare Community Plan, Blue Cross Blue Shield of Louisiana, Medicare Louisiana, and other commercial carriers.

Patient Billing Services

We manage patient statements and billing questions according to Louisiana Medicaid cost-sharing rules, Medicare patient-responsibility requirements, and commercial insurer benefit structures. This lowers front-office workload and supports stronger collection performance without unnecessary friction for patients.

Medical Coding Services

Our certified coders assign ICD-10-CM, CPT, and HCPCS codes according to Louisiana Medicaid rules, Medicare Louisiana guidelines, and commercial payer editing systems. Documentation is reviewed before billing to confirm medical necessity, coverage alignment, and encounter accuracy. This reduces audit exposure and prevents coding-related denials.

Insurance Verification Services

Eligibility and benefits are checked across Louisiana Medicaid (Bayou Health), all Bayou Health MCOs such as Aetna Better Health of Louisiana, Louisiana Healthcare Connections, and UnitedHealthcare Community Plan, as well as Medicare Louisiana and major commercial insurers including Blue Cross Blue Shield of Louisiana, Ambetter, UnitedHealthcare, Aetna, and Cigna. Deductibles, copays, referrals, coverage limits, and any authorization requirements are reviewed in advance so practices avoid payment disputes and delays.

Referral and Authorization Management

We manage authorizations for outpatient services, specialty care, diagnostic imaging, behavioral health programs, and therapy services across Louisiana. This includes strict alignment with Louisiana Medicaid prior-authorization lists, MCO service-plan requirements, and commercial insurer review rules. Preventing authorization errors reduces retroactive denials and protects clinic revenue.

Payment Posting

Payments are posted daily with ERA and EOB reconciliation. Underpayments, contractual discrepancies, and payer-processing errors are flagged immediately so corrections can be made before they impact revenue.

Old A/R Cleanup

Aged accounts are reviewed by payer, denial type, and service date. Correctable claims are updated and resubmitted. Inactive or inaccurate balances are cleared appropriately. This restores A/R accuracy and recovers revenue that would have been written off.

Medical Billing Write-Off Recovery

Historical write-offs are analyzed to identify recoverable revenue. Claims are corrected and resubmitted based on Louisiana Medicaid rules, Bayou Health MCO requirements, Medicare Louisiana guidelines, and commercial insurer policies. Recoverable payments are pursued without interrupting the clinic’s current billing cycle.

Accounts Receivable (A/R) Recovery

Each claim is reviewed before submission for coding accuracy, Louisiana authorization rules, correct modifiers, telehealth POS and modifier requirements, NPI validation, and any payer-specific billing instructions. After this review, claims move through clearinghouse checks that catch common rejection points and help practices get cleaner acceptance across Louisiana Medicaid, Medicare, and commercial payers.

Claims Submission

Before submission, each claim is reviewed for coding accuracy, Kansas authorization requirements, modifier accuracy, telehealth POS/modifiers, NPI validation, and payer-specific billing rules. Submissions move through clearinghouses with full pre-submission checks that reduce rejections and improve acceptance across Medicaid, Medicare, and commercial insurance plans.

Common Problems Louisiana Providers Face in Medical Billing

Complex Louisiana Medicaid, Bayou Health, and Commercial Payer Rules

Louisiana providers work across Louisiana Medicaid (Healthy Louisiana), its managed care organizations (Aetna Better Health, Healthy Blue, Louisiana Healthcare Connections, AmeriHealth Caritas, and UnitedHealthcare Community Plan), Medicare, and commercial insurers.

Each payer uses different rules for authorizations, therapy limits, BH documentation, referral requirements, and telehealth billing. Denials often occur when clinics use the wrong MCO policy, follow outdated prior-auth lists, select incorrect modifiers, or pick the wrong MCO assignment. Missing referrals, incorrect taxonomy, and mismatched diagnosis/CPT combinations are among the most common preventable denials in the state.

Frequent Louisiana Medicaid and MCO Policy Updates

Louisiana Medicaid and Healthy Louisiana MCOs release regular updates covering procedure limits, BH documentation, dental and pediatric rules, EPSDT criteria, modifier changes, and prior-authorization lists.
Commercial plans, including BCBS Louisiana, UHC, Aetna, Humana, and Ambetter, update their edits throughout the year. When clinics continue using old policy rules, outdated codes, or obsolete limits, they face reduced units, recoupments, or suspended claims.

Authorization Problems Across Louisiana MCOs

Louisiana MCO authorization issues often come from expired treatment plans, outdated units, mismatched CPT/ICD-10 pairs, unsigned progress notes, or authorizations that were never verified in the MCO portals. Clinics frequently bill CPT codes outside the approved mix or outside the date range. These errors lead to partial payments or full denials across Medicaid, MCOs, and commercial payers.

Strict Behavioral Health, Autism/ABA, Therapy, and EPSDT Limitations

Louisiana enforces strict documentation and unit limits for counseling, psychiatry, ABA, PT, OT, speech therapy, and pediatric EPSDT services. Denials often arise from missing session notes, unsigned treatment plans, insufficient measurable goals, incorrect telehealth modifiers, or missing time logs. BH programs, ABA providers, and therapy clinics experience the highest denial volume due to these documentation rules.

Coordination-of-Benefits Problems and Retroactive Plan Changes

COB issues are common when Medicaid becomes secondary, commercial plans terminate mid-month, or Healthy Louisiana MCO assignments switch retroactively. These changes lead to duplicate denials, suspended secondary claims, and “wrong primary payer” errors. Many Louisiana providers also face eligibility failures when new providers are not added correctly to the MCO rosters.

Long A/R Cycles Due to MCO Reprocessing Delays

Louisiana Medicaid MCOs often place claims into extended review cycles, request additional documentation, or require reconsiderations. Units not matching approved limits, missing encounter notes, or outdated authorizations slow payment resolution. This problem affects pediatrics, behavioral health, therapy groups, and primary care the most.

Audit Risks for Documentation, Time Logs, and Medical Necessity

Louisiana audits focus heavily on documented time, measurable treatment goals, signed notes, and medical-necessity justification. Clinics with incomplete progress notes, mismatched units, missing signatures, or incorrect group-session details face higher denial and audit exposure.
ABA and therapy providers face extra scrutiny for time-based codes, session logs, and treatment-plan cycles.

Provider Enrollment, Revalidation, and Roster Problems

Louisiana providers frequently encounter issues with Medicaid/Healthy Louisiana enrollment, NPI linking, missing service locations, incorrect taxonomy codes, or providers not appearing on MCO rosters. These errors trigger “provider not enrolled,” “invalid taxonomy,” “location not active,” and other pre-adjudication rejections.

Technical Rejections From MCOs and Clearinghouses

Technical rejections are common due to incorrect payer selection, wrong MCO assignment, missing attachments (especially for BH and therapy), invalid combinations, or clearinghouse formatting problems. These errors prevent claims from reaching Medicaid, MCOs, Medicare, or commercial insurers and create unnecessary rework.

How MZ Medical Billing Fixes These Problems for Louisiana Providers

Daily Billing Across Louisiana Medicaid, Healthy Louisiana MCOs, Medicare, and Commercial Plans

MZ Medical Billing works with claims across Louisiana Medicaid, Aetna Better Health, Healthy Blue, Louisiana Healthcare Connections, AmeriHealth Caritas, UnitedHealthcare Community Plan, Medicare, Humana, BCBS Louisiana, Aetna, Ambetter, and other commercial insurers.
We apply the correct rules for authorizations, therapy and BH limits, referral requirements, encounter documentation, and modifier usage for each payer. This cuts down on denials tied to MCO-specific rules and outdated billing instructions.

Real-Time Tracking of Louisiana Policy Changes

We monitor daily updates from Louisiana Medicaid, Healthy Louisiana MCOs, and commercial plans. Changes involving prior-auth lists, EPSDT limits, therapy caps, billing modifiers, time-based documentation rules, and encounter requirements are added directly into the billing workflow. This prevents claims from being submitted with outdated policies.

Authorization and Treatment-Plan Verification Before Billing

Every claim is reviewed for valid units, correct CPT/ICD-10 pairings, active dates, accurate documentation, and MCO authorization status. We verify approvals across MCO portals before billing to avoid denials tied to expired plans, incomplete treatment notes, or incorrect frequencies.

Handling COB Issues, Retroactive Plan Changes, and MCO Assignment Conflicts

Eligibility is checked in Louisiana Medicaid and MCO systems to confirm primary/secondary order and active plan assignment. We correct coverage changes, retroactive MCO switches, and crossover failures before submission. This reduces duplicate denials and suspended secondary claims that often increase A/R aging in Louisiana.

Denial Management and A/R Recovery for Louisiana Payers

Our team tracks denial trends across 30-, 60-, and 90-day cycles. We fix coding errors, correct documentation conflicts, resubmit claims, request reconsiderations, and challenge payer decisions when required. This helps stabilize cash flow for BH groups, therapy clinics, pediatrics, specialists, primary care, and group practices statewide.

Documentation Checks Based on Louisiana Medicaid and MCO Rules

We review progress notes, time logs, treatment plans, signatures, measurable goals, and frequency requirements to match Louisiana Medicaid and Healthy Louisiana rules. These checks help prevent common audit triggers tied to missing signatures, incorrect units, incomplete BH notes, or outdated therapy/ABA documentation cycles.

Enrollment, Revalidation, and MCO Roster Support

We handle Louisiana Medicaid enrollment, revalidation cycles, NPI linking, taxonomy corrections, and location setup. We also confirm that clinicians appear correctly on Healthy Louisiana MCO rosters. This avoids common denials such as “provider not enrolled,” “invalid taxonomy,” and “location not active.”

Technical Validation Before Claims Reach the Payer

Every claim goes through technical checks for correct payer selection, active MCO assignment, modifier accuracy, required attachments, updated policy rules, and clean EDI formatting. This increases first-pass acceptance across Louisiana Medicaid, MCOs, Medicare, and commercial plans.

Meet Our Expert Louisiana Medical Billing Team

Our Louisiana medical billing team includes certified billing and coding specialists who work daily with Louisiana Medicaid and all Healthy Louisiana MCOs, along with Medicare and major commercial insurers such as BCBS Louisiana, Humana, Aetna, Cigna, and Ambetter.

Each specialist supports Louisiana practices by preventing denials, improving documentation accuracy, and strengthening reimbursement in a system shaped by strict prior-authorization rules, EPSDT requirements, therapy limits, behavioral-health documentation standards, and routine MCO policy updates.

Expert Skill	What We Do
Certified Professionals	Our coders and billing specialists hold AAPC and AHIMA credentials and have direct experience with Louisiana Medicaid and all Healthy Louisiana MCOs. They apply Medicaid manuals, MCO authorization policies, payer-specific edits, and Louisiana documentation rules across behavioral health, pediatrics, therapy, primary care, and specialty practices statewide.
Payment & Reimbursement Analysis	We review ERAs, EOBs, and payer adjustments to identify underpayments, incorrect MCO reimbursements, outdated therapy or EPSDT changes, and inaccurate commercial-payer rate tables. This helps Louisiana providers recover missed revenue and maintain predictable cash flow across Medicaid, Medicare, and commercial claims.
Data-Driven Auditing	Our team evaluates claims using Louisiana Medicaid billing guidelines, MCO documentation requirements, and encounter-reporting standards. We flag coding conflicts, missing BH or therapy notes, unsigned treatment plans, incorrect unit calculations, and inconsistencies between approved and billed services before MCOs issue reductions or denials.
Denial Management & Appeals	We manage denials and appeals for Louisiana Medicaid, Healthy Louisiana MCOs, Medicare Advantage plans, and commercial insurers statewide. Our approach includes correcting data errors, validating authorization status, attaching required documentation, and submitting appeals according to each payer’s reconsideration and dispute procedures.
Compliance, HIPAA & Policy Monitoring	Louisiana Medicaid updates, Healthy Louisiana MCO policy revisions, commercial-payer code edits, and HIPAA mandates shift frequently. Our team tracks these changes daily and applies new modifiers, service caps, CPT/ICD updates, telehealth rules, and documentation standards immediately. This reduces audit exposure and prevents billing disruptions for Louisiana providers.

Why Louisiana Practices Should Consider Outsourcing Medical Billing

Outsourcing medical billing helps Louisiana healthcare providers move away from time-consuming claim work and focus on patient care. Instead of handling authorizations, denials, and ongoing policy changes, clinics can shift this work to a team that already works daily with Louisiana Medicaid, its managed-care plans, Medicare, and the major commercial insurers operating in the state.

Strategic Financial Management

We handle charge entry, claim submission, posting, and A/R reconciliation using Louisiana-specific rules and fee schedules. This keeps cash flow steady, shortens payment cycles, and reduces administrative pressure on clinic staff. Most practices see faster payment timelines and fewer interruptions caused by coding conflicts or outdated billing procedures.

Denial Prevention and Revenue Recovery

Denied claims are reviewed for documentation issues, inaccurate code combinations, missing authorizations, outdated coverage criteria, or billing that falls outside approved dates. Old write-offs are reassessed, and viable claims are corrected and resubmitted. Louisiana clinics often uncover recoverable revenue that in-house teams don’t have time to investigate.

Support for Complex Specialties

Therapy, behavioral health, pediatrics, and multi-specialty clinics in Louisiana work under strict documentation and treatment-plan rules. Our coders and billing specialists check units, signatures, treatment-cycle dates, and supporting notes before claims are sent out. This reduces audit exposure and cuts back on recoupments tied to technical billing issues.

Scalable Support for Expanding Practices

As Louisiana practices add new services, expand telehealth, open satellite locations, or increase patient volume, the billing workload grows quickly. Outsourced billing absorbs this growth without the clinic hiring or training additional staff. Multi-site groups benefit the most because each location’s claims stay consistent.

Regulatory and Policy Compliance

Louisiana Medicaid and its managed plans update coverage requirements, treatment limits, and authorization rules throughout the year. We track these updates and adjust workflows immediately so clinics avoid denials tied to outdated policies. This reduces recoupment risk and keeps documentation aligned with state and federal expectations.

Reporting and Operational Insight

Outsourced billing gives practices access to analytics dashboards and routine financial reports. Clinics can view payer trends, denial patterns, A/R aging, and reimbursement behavior clearly. This helps leadership make decisions using actual data, not guesswork.

Better Use of Staff Time

Internal staff avoid tasks like calling payers, managing appeals, and reviewing old A/R. This reduces burnout and lets front-office and clinical teams focus on intake, patient support, and care delivery. Even during staffing changes, billing stays consistent because workflows are handled externally.

Proactive Revenue Recovery

Historical claims are reviewed to identify missed payments. Issues like incorrect modifiers, wrong plan assignments, and outdated documentation are corrected so the claim can be resubmitted. This helps Louisiana clinics recover revenue that would otherwise be written off.

More Time for Patient Care

With billing, denials, authorizations, documentation checks, and A/R handled externally, Louisiana providers can give more attention to patients while still maintaining full visibility into their financial performance.

Louisiana Medical Billing & RCM Services – Expertise Across All 50 States

MZ Medical Billing Services provides full Medical Billing and Revenue Cycle Management (RCM) for healthcare providers in all 50 U.S. states, including Louisiana (Healthy Louisiana & commercial payers), Texas, Mississippi, Arkansas, Alabama, and every other state. Our team works with each state’s payer rules using accurate CPT/HCPCS coding, modifiers, documentation requirements, and authorization steps so providers receive correct and timely reimbursement.

In Louisiana, we apply the same precision for practices across New Orleans, Baton Rouge, Shreveport, Lafayette, Lake Charles, Monroe, Alexandria, and rural parishes. Claims are processed under Healthy Louisiana Medicaid guidelines, its MCOs (Aetna Better Health, AmeriHealth Caritas Louisiana, Healthy Blue, Louisiana Healthcare Connections, and UnitedHealthcare Community Plan), Medicare and Medicare Advantage plans, and commercial payers such as Blue Cross Blue Shield of Louisiana, Cigna, Aetna, UnitedHealthcare, Humana, and Ambetter. Each claim is checked for authorization validity, service limits, coding accuracy, and required documentation before submission, reducing preventable denials and supporting consistent cash flow.

By working with MZ Medical Billing Services, Louisiana providers gain a team experienced with nationwide billing systems and Louisiana-specific Medicaid rules, MCO programs, and commercial payer workflows. This produces accurate claim handling for clinics of all sizes and specialties, including primary care, pediatrics, behavioral health, therapy services, surgical specialties, and multi-location groups.

United States - States Map - Our Medical Billing Locations

Medical Billing Services for All Healthcare Specialties in Louisiana

MZ Medical Billing Services manages the full revenue cycle for healthcare providers across all specialties in Louisiana, supporting solo practices, hospitals, multi-specialty groups, outpatient centers, and specialty clinics throughout New Orleans, Baton Rouge, Shreveport, Lafayette, Lake Charles, Monroe, Alexandria, and rural parishes. Our team works with Louisiana Medicaid (Healthy Louisiana), Medicaid MCOs (Aetna Better Health, AmeriHealth Caritas Louisiana, Healthy Blue, Louisiana Healthcare Connections, UnitedHealthcare Community Plan), Medicare, and commercial payer requirements. Each claim follows Louisiana-specific rules for coding, documentation, authorization, and medical necessity.

We provide billing for:

Primary and Specialty Care – Family medicine, internal medicine, pediatrics, geriatrics, cardiology, endocrinology, nephrology, and multi-specialty groups. We manage chronic care coding, Louisiana Medicaid visit limits, and documentation checks for accurate claim submission.
Behavioral Health Services – Psychiatry, counseling, outpatient therapy, crisis services, IOP/IOP-P, ABA programs, and addiction recovery services. We review documentation for each session, track authorization units, and verify Louisiana Medicaid and MCO billing requirements.
Substance Use Treatment Centers – MAT clinics, outpatient addiction programs, IOP, PHP, and behavioral recovery centers. Our team reviews coding, documentation, medical necessity notes, and Louisiana Medicaid MCO compliance before claims are submitted.
Physical, Occupational, and Speech Therapy – Therapy session billing, modifier accuracy, EMR syncing, visit-limit tracking, and documentation review for therapy centers, hospital programs, and independent rehab practices across Louisiana.
Surgical and Hospital-Based Practices – General surgery, cardiology, orthopedics, anesthesia, GI, urology, ENT, podiatry, and other specialties requiring precise charge capture, post-operative claim review, and payer-specific compliance for Louisiana Medicare and commercial plans.
Chiropractic, Pain Management, and Integrative Medicine – Interventional pain procedures, spinal manipulation, acupuncture, physical medicine services, and treatment-plan checks with claim-level review for Louisiana payer rules.
Urgent Care, Walk-In, and Primary Care Clinics – E/M code validation, same-day claim submissions, high-volume processing, and telehealth billing aligned with Louisiana Medicaid and commercial payer requirements.
Imaging, Laboratory, and Diagnostic Services – Radiology, pathology, lab testing, imaging centers, and outpatient diagnostic facilities. We manage professional and technical component billing under Healthy Louisiana, Medicare, and commercial carriers.
Dental, Vision, and Ancillary Services – Dental-to-medical claims, DME and prosthetic billing, ophthalmology, audiology, and ambulatory surgery center workflows with submission checks across all Louisiana payers.
Community Health Centers, FQHCs, and RHCs – Billing for Federally Qualified Health Centers, rural health clinics, community clinics, LTACs, rehab hospitals, and facilities using PPS and state-specific reimbursement models.
Specialized Outpatient and Facility-Based Services – Behavioral therapy centers, outpatient surgical facilities, rehab programs, sleep labs, oncology infusion centers, dialysis clinics, and pain management programs with claim-level monitoring and financial reporting.
Home Health, Hospice, and Telehealth Services – Home health visits, hospice care, remote monitoring, telehealth sessions, and chronic care programs. We review coding, authorization requirements, visit limits, and documentation standards for all Louisiana payers.

MZ Medical Billing Services applies specialty-specific reporting, workflow coordination, and claim review across all Louisiana healthcare specialties, including emerging areas such as telebehavioral health, outpatient infusion programs, bariatric services, pediatric specialty care, and mobile health operations. These processes support accurate reimbursement, fewer denials, and stable revenue for providers across Louisiana.

Applied Behavior Analysis

Behavioural Health

Pediatric

Mental Health

Physical Therapy

Occupational Therapy

Speech Therapy

Anesthesiology

Radiology

Gynecology

Ambulatory

Urgent Care

Neuorology

Orthopedics

Cardiology

Chiropractic

Opthalmology

Oncology

Dental

Gastroentrology

Why Choose MZ Medical Billing in Louisiana

MZ Medical Billing supports Louisiana healthcare providers with certified billing specialists who work daily with Louisiana Medicaid (Healthy Louisiana), Medicaid MCOs (Aetna Better Health, AmeriHealth Caritas Louisiana, Healthy Blue, Louisiana Healthcare Connections, UnitedHealthcare Community Plan), Medicare, and commercial payers. Our team reviews coding accuracy, documentation completeness, and claim-level revenue patterns to support hospitals, physician groups, outpatient centers, and specialty practices across Louisiana and nationwide.

Local and Nationwide Support

We provide direct account management for providers in New Orleans, Baton Rouge, Shreveport, Lafayette, Lake Charles, Alexandria, Monroe, Houma, and rural parishes. Our nationwide billing coverage across all 50 states gives us insight into payer trends, Medicaid policies, and federal billing changes, which we apply directly to Louisiana Medicaid, its MCOs, and regional commercial payer workflows.

Data-Driven Billing Strategy

Each Louisiana provider account is reviewed using claim data, denial patterns, and payer adjustment reports. Our billing team pinpoints the reasons behind delayed or denied claims and applies corrections in your EHR or billing system. This reduces repeated errors and stabilizes reimbursement timelines across Louisiana Medicaid, Medicare, and commercial claims.

Certified and Compliant Billing

All billing is completed by AAPC- and AHIMA-certified specialists who follow HIPAA, CMS, and OIG rules. Compliance review includes Louisiana Medicaid advisories, MCO policy updates, Medicare and commercial payer coding changes, and CMS revisions. Each claim is aligned with current Louisiana Medicaid, MCO, and commercial payer requirements before submission.

Higher Collection Performance

Louisiana clients maintain strong first-pass approval rates and accounts receivable averages in the 27–30-day range. This performance is supported by denial tracking, corrective billing action, and direct follow-ups with Louisiana Medicaid, its MCOs, Medicare, and commercial carriers.

Established Payer Network

We manage billing relationships with all major Louisiana payers, including:

Louisiana Medicaid (Healthy Louisiana)
Medicaid MCOs: Aetna Better Health, AmeriHealth Caritas Louisiana, Healthy Blue, Louisiana Healthcare Connections, UnitedHealthcare Community Plan
Medicare and Medicare Advantage
Commercial carriers: BCBS Louisiana, Aetna, Cigna, UnitedHealthcare, Humana, Ambetter

Each payer’s rules for modifiers, documentation, prior authorization, and telehealth billing are applied before submission to reduce rejections and payment delays.

Transparent Financial Reporting

MZ Medical Billing provides monthly revenue reports covering claim status, denial causes, payer behavior, and recovery activity. Louisiana providers have full visibility into financial trends with audit-ready reporting and clear insight into reimbursement performance.

Patient-Focused Billing Communication

We prepare patient statements, manage payment plans, and respond to billing inquiries directly. This reduces administrative load for Louisiana clinic staff and improves patient understanding and payment consistency.

Long-Term Practice Growth

MZ Medical Billing maintains billing accuracy, watches Louisiana Medicaid and MCO updates, and adjusts billing workflows as payer rules shift. These processes support stable revenue, regulatory compliance, and long-term financial growth for healthcare organizations across Louisiana.

Louisiana Medical Billing & RCM Support

Serving New Orleans, Baton Rouge, Lafayette, Shreveport, and statewide parish clinics, MZ Medical Billing processes claims according to Louisiana Medicaid (Healthy Louisiana), Medicaid MCO rules, Medicare updates, and regional commercial payer requirements. We handle eligibility validation, CPT/HCPCS coding review, authorization checks, claim submission, denial correction, and A/R aging reduction across all Louisiana specialties.

Schedule a Free Louisiana RCM Audit
Our audit examines payer adjustments, authorization issues, documentation gaps, unresolved denials, and underpayments. You’ll receive a detailed report outlining where financial performance can be improved.

FAQS

Louisiana Medical Billing FAQs

How do I verify patient eligibility under Louisiana Medicaid (Healthy Louisiana)?

To verify eligibility, you can check the Louisiana Medicaid portal or each MCO’s member portal (Aetna Better Health, AmeriHealth Caritas Louisiana, Healthy Blue, Louisiana Healthcare Connections, UHC Community Plan). Look for active coverage dates, PCP assignment, and any prior-authorization requirements. MZ Medical Billing performs eligibility verification before every claim to prevent rejections and ensures that authorizations, service limits, and coverage rules are applied correctly.

How can I avoid denials due to prior authorizations in Louisiana Medicaid?

Prior authorization denials often happen when claims are submitted with expired authorizations, mismatched CPT/ICD-10 codes, or incorrect service dates. To prevent this:

Confirm authorization is valid for the service date.
Match CPT/ICD codes exactly to what was approved.
Use the correct MCO portal for verification.

MZ Medical Billing tracks all MCO authorizations and integrates them into claims to reduce denials.

What are the common billing errors in Louisiana Medicaid MCOs?

Frequent errors include:

Incorrect modifiers for telehealth or therapy services.
Missing or incomplete documentation for behavioral health and therapy sessions.
Submitting claims for non-covered services or outside approved units.
Duplicate claims caused by COB confusion.

We audit every claim for these errors before submission, reducing delays and recoupments.

How do I handle telehealth billing for Healthy Louisiana and its MCOs?

Telehealth rules vary:

Some MCOs require GT or 95 modifiers for live video sessions.
Audio-only sessions may only be reimbursed under certain plan types.
Place-of-service codes (POS) must match patient location.

MZ Medical Billing applies payer-specific telehealth rules at claim entry, avoiding rejections related to POS and modifier mistakes.

How do I correct a claim that was denied by a Louisiana Medicaid MCO?

First, identify the denial reason in the portal or ERA/EOB. Common causes are missing documentation, authorization issues, or coding mismatches. Submit a corrected claim with supporting documents and authorization info. Each MCO has specific timelines (usually 90–180 days). MZ Medical Billing maintains a correction workflow to resubmit claims quickly within these deadlines.

How do I manage Coordination of Benefits (COB) with Medicaid and commercial insurance in Louisiana?

COB issues occur when multiple plans cover the same patient. Problems include wrong primary/secondary assignment or delayed Medicare crossover. To resolve:

Verify payer order before submitting.
Update patient insurance info promptly.
Track crossover claims for proper posting.

MZ Medical Billing handles COB verification and ensures claims are sent to the correct payer in the correct order.

How can I reduce A/R aging for my Louisiana practice?

A/R aging increases when claims are under review, missing documentation, or denied repeatedly. To reduce A/R:

Submit clean, verified claims.
Follow up promptly on denials.
Track authorizations and plan updates.

MZ Medical Billing monitors payer portals daily, clears backlogged claims, and maintains A/R averages of 27–30 days for Louisiana practices.

What documentation is required for therapy and behavioral health claims in Louisiana?

Documentation must include:

Signed progress notes.
Treatment-plan dates aligned with authorization.
Measurable goals for each session.
Correct CPT/ICD codes.

Incomplete or missing documentation is a top reason for denials. MZ Medical Billing audits therapy and BH documentation before submission to reduce audit risk and prevent payment delays.

How do I stay compliant with Louisiana Medicaid audits?

Audits focus on:

Accurate coding and modifiers.
Complete encounter documentation.
Valid authorizations.
EPSDT compliance for pediatric services.
Telehealth POS and modifier adherence.

MZ Medical Billing maintains records, pre-submission audits, and detailed reporting to prepare providers for any state or federal review.

Can MZ Medical Billing help with patient billing and statements?

Yes. We handle patient statements, billing inquiries, and payment-plan tracking in line with Medicaid cost-sharing rules and commercial payer guidelines. This reduces front-office workload and ensures patients understand their responsibilities without creating friction.

How do I recover old write-offs or denied claims in Louisiana?

Old claims often sit unreviewed due to outdated authorizations, missed appeals, or payer errors. MZ Medical Billing audits historical claims, corrects errors, resubmits eligible claims, and recovers revenue that might otherwise be written off, improving cash flow for Louisiana practices.