Medical Billing Services in Wyoming
MedPrecision is a remote-first medical billing company. There is no MedPrecision office in Wyoming and no local team there; Wyoming practices are served remotely by AAPC-certified billing specialists working the state's own rules. Those rules are specific. Wyoming Medicaid runs as fee-for-service with no comprehensive risk-based managed care plans, so professional claims go straight to the state's fiscal agent, Acentra Health, under a 365-day clean-claim filing limit. Wyoming Statutes 26-15-124(a) then gives an insurer 45 days after it receives the proofs of loss and supporting evidence to reject or accept and pay a life, accident or health insurance claim — a deadline, not an automatic penalty, and one that binds only insurers the Wyoming Insurance Code governs, not self-funded employer plans, Medicare or Medicaid. What we bring to a Wyoming account is process: payer-segmented claim edits, follow-up cadences built on those two clocks, and appeals written against the rule the payer actually applied.
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The Wyoming Billing Landscape
Wyoming has not adopted the ACA Medicaid expansion and is one of ten states that have not, per KFF's expansion tracker published 21 August 2026. The Medicaid.gov state profile puts Wyoming at 59,917 people enrolled in Medicaid and CHIP as of May 2026 — a net decrease of 11.26 percent against the July-to-September 2013 baseline — and shows the parent and caretaker eligibility level at 45 percent of the federal poverty level with no adult expansion group. For a billing team that means a comparatively thin Medicaid share and a larger commercial and self-pay remainder than an expansion state produces. Wyoming Medicaid itself runs as fee-for-service with no comprehensive risk-based managed care plans: professional claims go to the state's fiscal agent, Acentra Health, on the CMS-1500 manual's rules rather than to a plan's provider-relations desk, and the one carve-out the manual names is Care Management Entity providers, who bill under their own agreement. Blue Cross Blue Shield of Wyoming, UnitedHealthcare, Cigna and Aetna are the commercial names that recur on Wyoming claims; we do not quote a market-share percentage for any of them, because no free primary source publishes one for this state. Geography is the other structural fact. The Census Bureau puts Wyoming's land area at 97,089 square miles with an estimated 588,753 residents as of 1 July 2025 and a 2020 density of 5.9 people per square mile, which is why critical access hospitals, rural health clinics and telehealth carry so much of the outpatient volume here. Parts of the state carry federal health professional shortage designations that can affect Medicare bonus eligibility, but that is an address-by-address question — check the practice location against HRSA's designation tool rather than assuming it qualifies. Two Wyoming clocks do more for cash flow than any of this context: the 365-day Medicaid filing limit, and the 60-calendar-day credentialing decision deadline in Wyoming Statutes 26-56-102, which also requires a carrier to reimburse back to the date it received a completed application once the provider is credentialed under an already-executed contract.
Who We Serve in Wyoming
Our Wyoming client mix skews toward solo practices, rural health clinics, critical access hospitals , plus family practice groups and telehealth providers. We work with providers in Cheyenne, Casper, Laramie and across the rest of the state, all remotely.
Major Metros Served
What billing costs in Wyoming
We publish one national rate card and bill Wyoming 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 Wyoming
Wyoming Medicaid (fee-for-service; no comprehensive risk-based managed care plans — claims go to the state's fiscal agent, Acentra Health) is the public payer our billing team codes against day-to-day. On the commercial side, Blue Cross Blue Shield of Wyoming, UnitedHealthcare, Cigna drive the bulk of Wyoming claim volume, so we maintain payer-specific denial playbooks and appeal templates for each. Claim clocks in Wyoming run 365 days for Medicaid and 90-180 days for commercial payers — deadlines our A/R queues are built around. Wyoming's prompt-pay statute: Wyoming Statutes 26-15-124(a) requires claims for benefits under a life, accident or health insurance policy to be rejected or accepted and paid within 45 days after receipt of the proofs of loss and supporting evidence, with exceptions where an accident and health claim's validity or amount is referred to the Wyoming state medical peer review committee and as authorized by W.S. 26-16-112(a) and 26-52-203. There is no automatic late-payment interest penalty: under subsection (c), a court may award a reasonable attorney's fee and interest at ten percent per year only where it determines the insurer refused to pay the full amount of a covered loss and that the refusal was unreasonable or without cause. The section binds insurers under the Wyoming Insurance Code, not self-funded employer plans, Medicare or Medicaid. Verified against Wyoming Statutes title 26 as published by the Wyoming Legislature on 17 September 2026.
Medicaid Program
Wyoming Medicaid (fee-for-service; no comprehensive risk-based managed care plans — claims go to the state's fiscal agent, Acentra Health)
Key Commercial Payers
Timely Filing Deadlines
Prompt Pay Law
Wyoming Statutes 26-15-124(a) requires claims for benefits under a life, accident or health insurance policy to be rejected or accepted and paid within 45 days after receipt of the proofs of loss and supporting evidence, with exceptions where an accident and health claim's validity or amount is referred to the Wyoming state medical peer review committee and as authorized by W.S. 26-16-112(a) and 26-52-203. There is no automatic late-payment interest penalty: under subsection (c), a court may award a reasonable attorney's fee and interest at ten percent per year only where it determines the insurer refused to pay the full amount of a covered loss and that the refusal was unreasonable or without cause. The section binds insurers under the Wyoming Insurance Code, not self-funded employer plans, Medicare or Medicaid. Verified against Wyoming Statutes title 26 as published by the Wyoming Legislature on 17 September 2026.
Wyoming Billing Regulations & Compliance
The Wyoming Department of Insurance sets the rules our Wyoming billing workflows have to satisfy. Surprise billing in Wyoming: Federal No Surprises Act applies. Wyoming's Insurance Code (title 26) carries no separate state surprise-billing or balance-billing chapter. Verified against Wyoming Statutes title 26 as published by the Wyoming Legislature on 17 September 2026. Telehealth parity: Wyoming Medicaid covers telehealth only as a real-time interactive audio and video encounter: telephone-only calls, email, fax and asynchronous store-and-forward consultations are excluded, the distant site bills modifier GT or 95 at the same code and rate as an in-person visit, and the originating-site facility fee Q3014 cannot be billed when the member used their own device (CMS-1500 Provider Manual version 19.0, section 6.23, effective 1 July 2026). The Wyoming Insurance Code contains no telehealth coverage mandate, so commercial telehealth coverage is set by each payer's contract rather than by state law. Verified 17 September 2026.
State Insurance Regulator
Wyoming Department of Insurance
Surprise Billing Protection
Federal No Surprises Act applies. Wyoming's Insurance Code (title 26) carries no separate state surprise-billing or balance-billing chapter. Verified against Wyoming Statutes title 26 as published by the Wyoming Legislature on 17 September 2026.
Telehealth Billing Parity
Wyoming Medicaid covers telehealth only as a real-time interactive audio and video encounter: telephone-only calls, email, fax and asynchronous store-and-forward consultations are excluded, the distant site bills modifier GT or 95 at the same code and rate as an in-person visit, and the originating-site facility fee Q3014 cannot be billed when the member used their own device (CMS-1500 Provider Manual version 19.0, section 6.23, effective 1 July 2026). The Wyoming Insurance Code contains no telehealth coverage mandate, so commercial telehealth coverage is set by each payer's contract rather than by state law. Verified 17 September 2026.
Common Questions
Common questions about medical billing services in Wyoming.
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Get a Free Billing AuditHow does MedPrecision handle Wyoming Medicaid fee-for-service billing?
Wyoming Medicaid runs as fee-for-service with no comprehensive risk-based managed care plans, so professional claims go to the state's fiscal agent rather than to a plan. The CMS-1500 Provider Manual version 19.0, effective 1 July 2026 and prepared for the Wyoming Department of Health by Acentra Health, sets the rules we work to. Section 6.19 requires a clean claim — the manual's term for an error-free, correctly completed claim with all required attachments — within 12 months (365 days) of the date of service; an adjustment must be made within 6 months of the date of service, while a void can be filed at any time without a timely-filing limit. For dually eligible members, Wyoming Medicaid requires taxonomy codes on every Medicare-primary submission for the billing, attending and servicing or rendering providers, and the Medicaid line items must match the Medicare claim exactly unless Medicare denied it. Whether a particular code is covered, needs prior authorization or carries a valid modifier is answered by the state's published fee schedule, not by us. Verified against the Wyoming Medicaid CMS-1500 Provider Manual version 19.0 (effective 1 July 2026) on 17 September 2026.
Can MedPrecision support frontier and rural practices in Wyoming?
We work remotely, which for a frontier practice is usually the only practical way to staff billing at all. What the work looks like depends on how the practice is paid, and those are different claim builds: a rural health clinic bills an encounter rate, a critical access hospital's professional services still go out on a CMS-1500 while its facility side runs on cost-report rules, and an independent practice is paid off the fee schedule. We scope which of those applies before quoting anything. We do not publish Wyoming client names, counts or case studies. Where cost-report or encounter-rate reimbursement is involved, the amounts turn on the applicable Medicare and Medicaid rules for your facility type and on your own professional advisers, not on a billing company's assurance.
What are Wyoming's timely filing requirements and how does MedPrecision manage them?
Wyoming Medicaid allows 12 months (365 days) from the date of service for a clean claim, under section 6.19 of the CMS-1500 Provider Manual. The manual's exceptions are narrow and each carries its own clock: a Medicare crossover claim must be filed within 365 days of the date of service or within 180 days of the payment date on the Explanation of Medicare Benefits, whichever is later; a claim for a member found eligible retroactively on appeal, reconsideration, court decision or agency corrective action must be filed within 180 days of that determination, with the dated notice attached and a cover letter requesting the exception. Commercial timely-filing limits are not set by Wyoming law at all — they come from each payer's contract, commonly in the 90-to-180-day range, so we read the contract rather than assume a number. We track every claim against whichever clock applies and escalate before it runs out. Verified against the Wyoming Medicaid CMS-1500 Provider Manual version 19.0 (effective 1 July 2026) on 17 September 2026.
Does MedPrecision support telehealth billing for remote Wyoming practices?
Yes, and Wyoming Medicaid's telehealth rules are narrower than most practices expect. Section 6.23 of the CMS-1500 Provider Manual defines telehealth as a real-time interactive audio and video link: the member must be able to see and interact with the offsite practitioner. A telephone conversation, an email, a fax, or an asynchronous store-and-forward consultation between two practitioners is not telehealth for this program. The same procedure codes and rates apply as in person, and the distant site appends modifier GT or 95, which does not change the fee. The originating site bills the facility fee under code Q3014 — but not when the member used their own phone, tablet or computer, and not for transmission charges or for an attendant. Care Management Entity providers are the exception: they bill place of service 02 under their own agreement and are instructed not to use GT, 95 or Q3014. Commercial telehealth coverage in Wyoming is a matter of contract rather than statute, so each payer's policy has to be checked separately. Verified against the Wyoming Medicaid CMS-1500 Provider Manual version 19.0 (effective 1 July 2026) on 17 September 2026.
What happens if a payer misses the Wyoming prompt-pay deadline?
Wyoming Statutes 26-15-124(a) requires that claims for benefits under a life, accident or health insurance policy be rejected or accepted and paid by the insurer, or by the agent it designates to receive claims, within 45 days after receipt of the proofs of loss and supporting evidence. The statute writes in its own exceptions: accident and health claims where there is a question as to the validity or the amount of the claim and the question is referred to the Wyoming state medical peer review committee, plus the exceptions authorized by W.S. 26-16-112(a) and 26-52-203. There is no automatic late-payment interest penalty. Subsection (c) is the remedy, and it is narrower than a prompt-pay penalty: in an action against the insurer, where a court determines that the company refused to pay the full amount of a covered loss and that the refusal was unreasonable or without cause, the court may award a reasonable attorney's fee and interest at ten percent per year. Note also what the section does not reach — self-funded employer plans governed by ERISA, Medicare and Medicaid sit outside the Wyoming Insurance Code. We track clean claims against the 45-day mark, flag stalled payments in A/R reporting, and raise them with the payer and, where warranted, with the Wyoming Department of Insurance. Verified against Wyoming Statutes title 26 as published by the Wyoming Legislature on 17 September 2026.
How do I choose a medical billing company in Wyoming?
Prioritize a billing company that already works Wyoming Medicaid's fee-for-service rules and the commercial contracts your practice actually holds; payer-specific edits and filing windows are where claims most often stall. Ask about AAPC-certified coders, transparent pricing, and denial-rate and days-in-A/R reporting before you sign. Ask about credentialing too, because Wyoming gives you a deadline to hold a carrier to: Wyoming Statutes 26-56-102 requires a health carrier to acknowledge a credentialing application within 7 calendar days, to notify the applicant of an incomplete application within 30 calendar days, and to conclude credentialing within 60 calendar days of receiving the application. Where the provider is credentialed and a fully executed contract was already in effect before the services were provided, the carrier must reimburse back to the date it received the completed application, unless federal law preempts. Because billing is delivered remotely, a company's Wyoming payer experience matters more than a local office address. Verified against Wyoming Statutes title 26 as published by the Wyoming Legislature on 17 September 2026.
Services for Wyoming practices
Specialties we bill for
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Services in Wyoming
Specialties in Wyoming
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