Medical Billing Services in Louisiana
Billing, coding, credentialing and denial management for Louisiana practices, with Medicare claims through Novitas Solutions (Jurisdiction JH) and Louisiana Medicaid handled by people who know the rules.
Medical billing for Louisiana practices
Louisiana has a large Medicaid population, and almost all members are enrolled in Healthy Louisiana managed care. The plan line-up is changing fast. UnitedHealthcare's Medicaid contract ended March 31, 2026, and the state is ending its Healthy Blue contract effective December 31, 2026, which moves more than 290,000 members to the four remaining plans. Practices in New Orleans and Baton Rouge also bill a commercial market led by Blue Cross and Blue Shield of Louisiana.
SFA Solutions works with Louisiana practices remotely. We bill Medicare Part B through Novitas, keep your Louisiana Medicaid enrollment active so Healthy Louisiana plans can pay you, and work denials across Aetna, AmeriHealth Caritas, Humana and Louisiana Healthcare Connections. During plan transitions, we verify coverage before each visit and submit most clean claims within 24 hours.
Louisiana at a glance
| Medicare contractor | Novitas Solutions, Jurisdiction JH |
|---|---|
| Medicaid timely filing | Healthy Louisiana plans set timely filing limits in their provider contracts, and fee-for-service claims follow the LDH provider manual, so confirm the current limit with each payer |
| NP practice authority | Reduced |
| Cities we serve | New Orleans, Baton Rouge, Shreveport, Lafayette, Lake Charles, Kenner, Bossier City, Monroe, Alexandria, Houma |
What Louisiana billing involves
These are the programs and rules our team works with for Louisiana claims.
Medicare
Novitas Solutions · JHLouisiana Part B claims are processed by Novitas Solutions in Jurisdiction JH. Medicare's filing limit is 12 months from the date of service, and appeals start with a redetermination within 120 days of the initial decision.
Louisiana Medicaid
Louisiana Medicaid, administered by the Louisiana Department of Health (LDH); Healthy Louisiana managed care; LaCHIP for children
Portal: LDH Medicaid Provider Enrollment Portal for enrollment and revalidation; fee-for-service claims through the Louisiana Medicaid fiscal intermediary, Gainwell Technologies
Medicaid managed care
Healthy Louisiana plans are Aetna Better Health of Louisiana, AmeriHealth Caritas Louisiana, Humana Healthy Horizons in Louisiana, Louisiana Healthcare Connections and Healthy Blue through December 31, 2026. Healthy Blue members move to one of the other four plans on January 1, 2027.
Timely filing
Healthy Louisiana plans set timely filing limits in their provider contracts, and fee-for-service claims follow the LDH provider manual, so confirm the current limit with each payer.
Commercial and Medicare Advantage
Blue Cross and Blue Shield of Louisiana holds the largest commercial share, with UnitedHealthcare, Aetna, Cigna and Vantage Health Plan also active. Humana, UnitedHealthcare (including Peoples Health) and Blue Cross lead Medicare Advantage enrollment.
Prompt pay law
La. R.S. 22:1833 requires issuers to pay, deny or pend electronic clean claims within 25 days of receipt. Under La. R.S. 22:1832, nonelectronic clean claims filed within 45 days of service must be paid, denied or pended within 45 days of receipt, or within 60 days for later or resubmitted claims. Late payments to providers carry a 12% annual adjustment.
Nurse practitioners
Reduced practiceLouisiana NPs must keep a collaborative practice agreement with a physician. Payers usually request the agreement during credentialing, and NPs can enroll and bill under their own NPI with Medicare, Medicaid and most commercial plans.
Credentialing
Louisiana requires every provider serving Medicaid members, including those who bill only Healthy Louisiana plans, to enroll through the LDH Medicaid Provider Enrollment Portal. Plans deny claims for providers without active state enrollment. Blue Cross and Blue Shield of Louisiana and most commercial carriers use CAQH ProView, which should be re-attested every 120 days.
Billing challenges Louisiana practices face
Medicaid plan exits
With UnitedHealthcare out in 2026 and Healthy Blue ending December 31, 2026, many patients will carry outdated cards into 2027. Claims sent to a plan that no longer covers the member deny and burn filing time. We verify each patient's current plan before the visit.
Credentialing with new plans
When members move to Aetna, AmeriHealth Caritas, Humana or Louisiana Healthcare Connections, practices need active contracts with those plans to keep seeing them in network. Credentialing gaps mean lost visits or out of network denials. We review your participation with all four plans and start any missing applications.
State enrollment requirement
LDH matches every managed care claim to the provider's state Medicaid enrollment. Providers who never completed the LDH enrollment, or let revalidation lapse, see plan denials even with signed contracts. We confirm enrollment status during onboarding and track revalidation dates.
Our services in Louisiana
Medical Billing
Learn moreCredentialing & Payer Enrollment
Learn moreMedical Coding
Learn moreDenial Management
Learn moreA/R Recovery
Learn moreEligibility Verification & Prior Authorization
Learn moreMedical Billing Audit
Learn moreRevenue Cycle Management
Learn moreSpecialties we bill in Louisiana
Louisiana medical billing questions
What is the timely filing limit for Louisiana Medicaid?
Each Healthy Louisiana plan sets its filing limit in its provider contract, so check the plan's provider manual before claims age. Fee-for-service limits are set in the LDH provider manual. Members with retroactive eligibility can have different deadlines.
Which plans will serve Louisiana Medicaid in 2027?
Starting January 1, 2027, Healthy Louisiana members will be enrolled with Aetna Better Health, AmeriHealth Caritas Louisiana, Humana Healthy Horizons in Louisiana or Louisiana Healthcare Connections. Healthy Blue's contract ends December 31, 2026.
Who is the Medicare contractor for Louisiana?
Novitas Solutions is the Jurisdiction H (JH) A/B MAC for Louisiana, along with Arkansas, Colorado, Mississippi, New Mexico, Oklahoma and Texas. Enrollment changes go through PECOS.
How fast must Louisiana insurers pay clean claims?
Under La. R.S. 22:1833, electronic clean claims must be paid, denied or pended within 25 days of receipt. Under La. R.S. 22:1832, a paper clean claim filed within 45 days of service must be handled within 45 days of receipt, and claims filed later or resubmitted have 60 days. Late provider payments carry a 12% annual adjustment.
Get a free billing audit for your Louisiana practice
We will review your recent claims and denials against Louisiana payer rules and show you what can be recovered.
Nearby states
Primary sources
- LDH: Transition for Healthy Blue members ahead of contract's conclusion
- LDH: Contract with UnitedHealthcare closed out March 31, 2026
- La. R.S. 22:1832 (nonelectronic claims)
- La. R.S. 22:1833 (electronic claims)
- CMS: Who Are the MACs
- Louisiana State Board of Nursing: Collaborative Practice Agreement template
Payer rules change. Last reviewed against the primary sources above on . Confirm current rules with the payer before relying on them.
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