Pennsylvania’s healthcare market is split between two major corridors: the Philadelphia metro in the east and the Pittsburgh metro in the west, with a vast rural landscape in between. Each region has its own dominant payers, and billing correctly here means understanding Highmark BCBS, Independence Blue Cross, UPMC Health Plan, Geisinger, and the state’s Medicaid managed care organizations. Go Medical Billing serves PA practices from Philly to Pittsburgh and every county in between.
Two Distinct BCBS Markets
Eastern PA runs on Independence Blue Cross and its subsidiaries. Western PA is Highmark territory. UPMC Health Plan competes aggressively in the west. Each operates with different fee schedules, authorization portals, and claims rules. A billing company that treats all BCBS plans the same will cost you money in PA.
Pennsylvania Medicaid (MA) Managed Care
PA HealthChoices routes Medicaid beneficiaries through managed care organizations including AmeriHealth Caritas, UPMC for You, Geisinger, Aetna Better Health, and United. We credential and bill with every PA Medicaid MCO.
Medicare in Pennsylvania
Medicare Part B in PA is processed by Novitas Solutions. We apply Novitas specific LCD policies to every PA Medicare claim to prevent medical necessity denials.
Starting at 2.49% of net collections. A full time biller in the Philly or Pittsburgh market costs $40,000 to $55,000 before benefits. Our entire team costs less.
Which PA payers do you work with?
Highmark, Independence Blue Cross, UPMC Health Plan, Geisinger, Aetna, Cigna, UHC, all PA Medicaid MCOs, and Medicare (Novitas).
Do you serve rural PA practices?
Yes. We work with practices across all 67 PA counties. Rural practices often have a heavier Medicare/Medicaid mix, and we optimize billing for that payer composition.
Call 888 701 6090 for a free Pennsylvania billing assessment.
