Medical Billing Services in Louisiana
As a remote-first medical billing company serving Louisiana practices statewide, MedPrecision pairs LA-specific payer expertise with AAPC-certified billing experts. Louisiana Revised Statutes 46:460.70 bars the department and every Healthy Louisiana managed care organization from limiting claim submission to less than 365 days from the date of service, so that statutory floor, not a shorter number in a plan manual, is the clock we work. On the commercial side, Blue Cross Blue Shield of Louisiana dominates Louisiana's payer mix, which means fee-schedule accuracy and disciplined appeals are non-negotiable for practices in the state. Louisiana Revised Statutes 22:1833(B)(1) requires a health insurance issuer to pay, deny, or pend an electronic clean claim within 25 days of receiving it, and R.S. 22:1832(A)(1) allows 45 days for a paper clean claim submitted within 45 days of the date of service — 60 days under (A)(2) if the paper claim goes in later than that or is resubmitted — so prompt-pay tracking is part of every weekly A/R review we run for Louisiana accounts. MedPrecision's Louisiana workflow layers payer-specific scrubbers, MCO portal logins, and deadline-aware A/R follow-up: each claim is checked against the plan's own edits before it leaves, and each stalled one is worked against its filing and appeal dates rather than left to age. Statute and plan facts on this page were verified against the Louisiana State Legislature's published statutes and the Louisiana Department of Health on 17 September 2026.
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The Louisiana Billing Landscape
Louisiana expanded Medicaid in 2016, which reshaped the state's payer landscape. The Healthy Louisiana managed care program contracts with Aetna Better Health of Louisiana, AmeriHealth Caritas Louisiana, Healthy Blue, Humana Healthy Horizons in Louisiana, and Louisiana Healthcare Connections (Centene); the UnitedHealthcare plan has not been available to Medicaid members since 1 April 2026, per the Louisiana Department of Health, verified 17 September 2026. Blue Cross Blue Shield of Louisiana is the dominant commercial carrier, with significant market share across the state. Louisiana's prompt pay law requires an issuer to pay, deny, or pend an electronic clean claim within 25 days of receipt under R.S. 22:1833(B)(1), with a late payment adjustment of 12 percent per annum where it does not. The state's healthcare needs are shaped by high rates of chronic disease, particularly diabetes, hypertension, and obesity, driving demand for chronic care management billing expertise. Hurricane exposure and disaster recovery regularly disrupt practice operations and create billing continuity challenges. Ochsner Health System and LCMC Health are the dominant health systems, particularly in the New Orleans metro, while rural Louisiana depends on critical access hospitals and federally qualified health centers. Louisiana bars an insurer from denying payment to the originating-site physician who is present with the patient during a telehealth encounter, and sets that physician's payment floor at 75 percent of an intermediate office visit (R.S. 22:1821(F)). The state's unique parish-based governance can create billing complexities around regional Medicaid administration.
Who We Serve in Louisiana
Our Louisiana client mix skews toward solo practices, group practices, federally qualified health centers , plus rural health clinics and telehealth providers. We work with providers in New Orleans, Baton Rouge, Shreveport and across the rest of the state, all remotely.
Major Metros Served
What billing costs in Louisiana
We publish one national rate card and bill Louisiana practices on exactly the same terms as everywhere else — there is no regional markup and no quote-only tier below enterprise. You pay a percentage of what we actually collect, so if we do not collect, you do not pay.
| Practice size | Rate | Basis | Note |
|---|---|---|---|
| Solo practice | 7.0% | of monthly collections | Monthly minimum applies |
| Group practice | 6.0% | of monthly collections | Volume discounts available |
| Enterprise | Custom | tiered pricing | Scoped per engagement |
- No setup or implementation fee
- No per-claim charge
- No software fee and no markup on third-party costs — clearinghouse fees, postage and payer application fees are passed through at cost
- 12-month initial term, then month-to-month — 60 days' notice either way, no early-termination penalty
Payer Landscape in Louisiana
Healthy Louisiana (Medicaid managed care) routes members through Aetna Better Health of Louisiana, AmeriHealth Caritas Louisiana, Healthy Blue and 2 more plans, each with its own authorization rules and fee schedule. On the commercial side, Blue Cross Blue Shield of Louisiana, UnitedHealthcare, Aetna drive the bulk of Louisiana claim volume, so we maintain payer-specific denial playbooks and appeal templates for each. Claim clocks in Louisiana run 365 days for Medicaid and 90-180 days for commercial payers — deadlines our A/R queues are built around. Louisiana's prompt-pay statute: Louisiana Revised Statutes 22:1833(B)(1) requires a health insurance issuer to pay, deny, or pend an electronic clean claim within 25 days of receipt. R.S. 22:1832(A)(1) allows 45 days for a paper clean claim submitted within 45 days of the date of service, and (A)(2) allows 60 days where the paper claim was submitted later than that or resubmitted because the original was not clean. A provider not paid within those windows is owed a late payment adjustment equal to 12 percent per annum of the amount due. The Subpart does not apply to the Office of Group Benefits. R.S. 22:1821(A) is a separate, insured-side rule — thirty days from written notice and proof of claim, with a penalty of double the benefits due payable to the insured plus attorney fees. Verified 17 September 2026.
Medicaid Program
Healthy Louisiana (Medicaid managed care)
Managed Care Organizations
Key Commercial Payers
Timely Filing Deadlines
Prompt Pay Law
Louisiana Revised Statutes 22:1833(B)(1) requires a health insurance issuer to pay, deny, or pend an electronic clean claim within 25 days of receipt. R.S. 22:1832(A)(1) allows 45 days for a paper clean claim submitted within 45 days of the date of service, and (A)(2) allows 60 days where the paper claim was submitted later than that or resubmitted because the original was not clean. A provider not paid within those windows is owed a late payment adjustment equal to 12 percent per annum of the amount due. The Subpart does not apply to the Office of Group Benefits. R.S. 22:1821(A) is a separate, insured-side rule — thirty days from written notice and proof of claim, with a penalty of double the benefits due payable to the insured plus attorney fees. Verified 17 September 2026.
Louisiana Billing Regulations & Compliance
The Louisiana Department of Insurance sets the rules our Louisiana billing workflows have to satisfy. Surprise billing in Louisiana: The federal No Surprises Act applies. Louisiana also has emergency-claim rules of its own: R.S. 22:1821(D)(2) requires an insurer, HMO, PPO, or other managed care organization whose policy includes emergency medical services to pay providers for emergency services rendered to a patient who presents with an emergency medical condition, and bars it from retrospectively denying or reducing that payment if screening later shows the condition was not a true emergency — subject to listed exceptions for misrepresentation, fraud, omission, clerical error, patient cost sharing, and cases where the definition is not met and there was no referral. Those provisions do not apply to plans established under and regulated by ERISA. R.S. 22:1826 separately addresses payment of claims for emergency services provided by noncontracted providers. Verified 17 September 2026. Telehealth parity: Louisiana Revised Statutes 22:1821(F) provides that where a policy covers a healthcare service — diagnostic testing, treatment, referral, or consultation among them — and the service is performed via transmitted electronic imaging or telehealth, payment may not be denied to the licensed physician at the originating facility who is physically present with the patient and is contemporaneously communicating with a licensed physician at the receiving end, and payment to that originating-site physician may not be less than 75 percent of the reasonable and customary amount that physician receives for an intermediate office visit. Telehealth services remain subject to the insurer's utilization review criteria, and the subsection does not apply to limited benefit health insurance policies. Verified 17 September 2026.
State Insurance Regulator
Louisiana Department of Insurance
Surprise Billing Protection
The federal No Surprises Act applies. Louisiana also has emergency-claim rules of its own: R.S. 22:1821(D)(2) requires an insurer, HMO, PPO, or other managed care organization whose policy includes emergency medical services to pay providers for emergency services rendered to a patient who presents with an emergency medical condition, and bars it from retrospectively denying or reducing that payment if screening later shows the condition was not a true emergency — subject to listed exceptions for misrepresentation, fraud, omission, clerical error, patient cost sharing, and cases where the definition is not met and there was no referral. Those provisions do not apply to plans established under and regulated by ERISA. R.S. 22:1826 separately addresses payment of claims for emergency services provided by noncontracted providers. Verified 17 September 2026.
Telehealth Billing Parity
Louisiana Revised Statutes 22:1821(F) provides that where a policy covers a healthcare service — diagnostic testing, treatment, referral, or consultation among them — and the service is performed via transmitted electronic imaging or telehealth, payment may not be denied to the licensed physician at the originating facility who is physically present with the patient and is contemporaneously communicating with a licensed physician at the receiving end, and payment to that originating-site physician may not be less than 75 percent of the reasonable and customary amount that physician receives for an intermediate office visit. Telehealth services remain subject to the insurer's utilization review criteria, and the subsection does not apply to limited benefit health insurance policies. Verified 17 September 2026.
Common Questions
Common questions about medical billing services in Louisiana.
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Get a Free Billing AuditDoes MedPrecision handle Healthy Louisiana MCO billing?
Yes. Healthy Louisiana runs through Aetna Better Health of Louisiana, AmeriHealth Caritas Louisiana, Healthy Blue, Humana Healthy Horizons in Louisiana, and Louisiana Healthcare Connections. UnitedHealthcare is no longer among them — the Louisiana Department of Health confirms the UnitedHealthcare plan has not been available to Medicaid members since 1 April 2026, and former members moved to a new plan on that date (verified 17 September 2026). If your remittances still route to a UnitedHealthcare Medicaid ID, that is the first thing we clean up. We bill the current plans and stay current on each one's authorization requirements, fee schedules, and submission rules.
How does MedPrecision handle Louisiana prompt pay law compliance?
Louisiana Revised Statutes 22:1833(B)(1) gives a health insurance issuer 25 days to pay, deny, or pend an electronic clean claim, and R.S. 22:1832(A)(1) gives it 45 days for a paper clean claim submitted within 45 days of the date of service. There is an earlier clock worth working: under R.S. 22:1833(A)(2) the issuer has five working days from receipt of an electronic claim to review it and, if it is not an accepted claim, issue an exception report naming every defect then known — and a provider whose claim was not accepted is deemed to have filed timely if the issuer failed to send that report. We submit clean electronic claims on first pass, read the exception reports rather than waiting on the remittance, and escalate when a payer misses a deadline.
How has Medicaid expansion affected billing volume for Louisiana practices?
Louisiana expanded Medicaid in 2016, and the coverage gains since then reshaped the payer mix many practices bill against — more Medicaid managed care volume, and with it more plan-specific authorization and filing rules. We help you manage that by handling the submission volume, verifying eligibility before the visit, and tracking timely filing against the 365-day floor R.S. 46:460.70 sets for Medicaid claims, which no Healthy Louisiana plan may shorten.
What specialties does MedPrecision support in Louisiana?
We support a wide range of specialties across Louisiana, including family practice, behavioral health, cardiology, urgent care, physical therapy, and more. Our billers are trained on specialty-specific coding for both Healthy Louisiana MCOs and commercial payers operating in the state.
What happens if a payer misses the Louisiana prompt-pay deadline?
Two different Louisiana rules get confused here, so it is worth separating them. The provider-side clock is in R.S. 22:1831 through 22:1838: an electronic clean claim must be paid, denied, or pended within 25 days of receipt under R.S. 22:1833(B)(1); a paper clean claim submitted within 45 days of the date of service gets 45 days under R.S. 22:1832(A)(1), and 60 days under (A)(2) if it was submitted later than that or resubmitted because the original was not clean. A provider not paid inside those windows is owed a late payment adjustment equal to 12 percent per annum of the amount due. That Subpart does not apply to the Office of Group Benefits. The other rule, R.S. 22:1821(A), is an insured-side remedy: it requires claims under health and accident contracts to be paid within thirty days of written notice and proof of claim and, on failure, sets a penalty of double the benefits due payable to the insured, plus attorney fees — it is not the provider prompt-pay penalty. Separately, the Louisiana Department of Health runs an independent review process under R.S. 46:460.81 et seq. for disputed managed care claims, and treats an MCO's failure to send a remittance advice or other written or electronic notice within 60 days of receiving the claim as a denial; a review request carries a fee of $750, paid by whichever side loses. We track every clean claim against these deadlines, flag stalled payments in our A/R reports, and escalate to the Louisiana Department of Insurance when a commercial payer defaults. Verified against the Louisiana State Legislature's published statutes and the Louisiana Department of Health on 17 September 2026.
How do I choose a medical billing company in Louisiana?
Prioritize a billing company that already works with Healthy Louisiana and the major commercial payers in Louisiana — payer-specific edits and timely-filing windows are where most LA revenue leaks start. Ask about AAPC-certified coders, transparent pricing, and denial-rate and days-in-A/R reporting before you sign. Because billing is delivered remotely, a company's Louisiana payer experience matters more than a local office address.
Services for Louisiana practices
Specialties we bill for
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Services in Louisiana
Specialties in Louisiana
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