Medical Billing Services in New Hampshire
Billing, coding, credentialing and denial management for New Hampshire practices, with Medicare claims through National Government Services (Jurisdiction JK) and New Hampshire Medicaid handled by people who know the rules.
Medical billing for New Hampshire practices
New Hampshire practices see a payer mix tilted toward commercial coverage, with Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care and Cigna among the largest carriers. National Government Services processes Medicare Part B under Jurisdiction K, and NH Medicaid runs most members through Medicaid Care Management with three health plans.
Practices along the southern border also treat many Massachusetts residents, so MassHealth and Massachusetts plans show up on the schedule. New Hampshire's prompt pay law is also one of the tighter ones, at 15 calendar days for clean electronic claims. SFA Solutions works with New Hampshire practices remotely, from Manchester and Nashua to the Seacoast and the North Country.
New Hampshire at a glance
| Medicare contractor | National Government Services, Jurisdiction JK |
|---|---|
| Medicaid timely filing | 1 year from the date of service for fee-for-service claims; Medicaid Care Management plans set their own limits |
| NP practice authority | Full |
| Cities we serve | Manchester, Nashua, Concord, Derry, Dover, Rochester, Salem, Portsmouth, Keene, Laconia |
What New Hampshire billing involves
These are the programs and rules our team works with for New Hampshire claims.
Medicare
National Government Services · JKNew Hampshire Part B claims are processed by National Government Services in Jurisdiction JK. 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.
New Hampshire Medicaid
New Hampshire Medicaid; Granite Advantage Health Care Program for expansion adults
Portal: NH MMIS provider portal (nhmmis.nh.gov) for enrollment, eligibility and fee-for-service claims, with Conduent handling claims processing and provider relations for the Department of Health and Human Services
Medicaid managed care
Most members are enrolled in Medicaid Care Management with one of three health plans: AmeriHealth Caritas New Hampshire, NH Healthy Families and WellSense Health Plan.
Timely filing
1 year from the date of service for fee-for-service claims; Medicaid Care Management plans set their own limits.
Commercial and Medicare Advantage
Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care, Cigna and Ambetter from NH Healthy Families are the major commercial carriers. Humana, Anthem and Aetna all offer Medicare Advantage plans in the state.
Prompt pay law
Under RSA 420-J:8-a, carriers must pay clean claims within 15 calendar days of receipt for electronic claims and 30 calendar days for paper claims.
Nurse practitioners
Full practiceNew Hampshire NPs evaluate, diagnose and prescribe independently, without a required collaborative agreement. They enroll with Medicare, NH Medicaid and commercial plans under their own NPI.
Credentialing
Providers enroll with NH Medicaid through the NH MMIS portal, then credential separately with AmeriHealth Caritas, NH Healthy Families and WellSense. Practices that see Massachusetts residents may also need MassHealth enrollment as an out-of-state provider. Anthem, Harvard Pilgrim and Cigna use CAQH ProView, so keep your attestation current every 120 days.
Billing challenges New Hampshire practices face
Three Medicaid health plans
AmeriHealth Caritas New Hampshire, NH Healthy Families and WellSense each have their own authorization rules, payer IDs and claim edits. Patients can switch plans. We verify plan assignment before every visit so claims go to the right plan.
Massachusetts patients across the border
Practices in Nashua, Salem and the Seacoast treat many Massachusetts residents with MassHealth or Massachusetts commercial plans. MassHealth has a 90-day filing limit and its own enrollment rules. We handle out-of-state payer setup and submit most of those clean claims within 24 hours.
Using the 15-day prompt pay rule
New Hampshire requires carriers to pay clean electronic claims within 15 calendar days, one of the shorter windows in the country. Many practices never hold carriers to it. We age commercial claims against that clock and follow up when payment is late.
Our services in New Hampshire
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 New Hampshire
New Hampshire medical billing questions
What is the timely filing limit for New Hampshire Medicaid?
Fee-for-service NH Medicaid claims must be filed within one year of the date of service through the NH MMIS. Late claims can be appealed with a timely filing override request when there is a valid reason. Medicaid Care Management plans set their own limits.
Who is the Medicare contractor for New Hampshire?
National Government Services (NGS) is the A/B Medicare Administrative Contractor for New Hampshire under Jurisdiction K (JK). NGS processes Part B claims and redeterminations, and enrollment changes go through PECOS.
How fast must New Hampshire insurers pay clean claims?
RSA 420-J:8-a requires carriers to pay clean claims within 15 calendar days for electronic claims and 30 calendar days for paper claims. If a claim is denied or pended, the carrier must give the reason within the same timeframes. Self-funded employer plans follow federal ERISA rules instead.
Can SFA Solutions bill for my New Hampshire practice remotely?
Yes. We work inside your existing EHR or practice management system remotely and handle charge entry, claim submission, denials and A/R follow-up for New Hampshire practices. We can typically begin within 24 hours of receiving system access.
Get a free billing audit for your New Hampshire practice
We will review your recent claims and denials against New Hampshire payer rules and show you what can be recovered.
Nearby states
Primary sources
- CMS: Who are the MACs, A/B MAC Jurisdiction K (JK)
- NH DHHS: Medicaid Care Management
- NH DHHS: MMIS Claims Submission Overview
- RSA 420-J:8-a: Prompt Payment Required
- RSA 326-B: Nurse Practice Act (APRN scope, RSA 326-B:11)
- MassHealth: Submit a 90-day Claim Waiver Request Form
Payer rules change. Last reviewed against the primary sources above on . Confirm current rules with the payer before relying on them.
Request your free practice audit
An RCM specialist typically replies within one business day.