Credentialing in Louisiana
Soft Home Global provides payer enrollment, revalidation and follow-up for Louisiana practices and billing companies at $2,200 per seat per month. Full time, worked during Louisiana business hours, inside your own system.
What is specific to Louisiana
Louisiana expanded Medicaid in 2016 and delivers most of the program through Healthy Louisiana managed care plans, while Blue Cross and Blue Shield of Louisiana remains the dominant commercial carrier.
Louisiana’s Medicaid program is Louisiana Medicaid (Healthy Louisiana). Practices with a meaningful Louisiana Medicaid (Healthy Louisiana) mix usually need it worked as its own queue rather than mixed into commercial follow-up, because the submission path, the timely filing window and the appeal route are all different.
Medicare here is adjudicated by Novitas Solutions, jurisdiction JH — shared with Arkansas, Mississippi and Texas. CMS publishes the jurisdictions; checked September 2026.
What a credentialing seat does in Louisiana
Applications, revalidations and payer follow-up, with every enrollment's status visible.
Louisiana Medicaid (Healthy Louisiana) is not one enrollment but one per plan, and every one of them has a revalidation date that stops payment when it passes. That calendar is the work.
- Initial applications prepared and submitted
- Revalidations tracked ahead of the deadline
- CAQH kept current
- Payer follow-up until an effective date is issued
- Status of every enrollment visible to you
- Worked during Louisiana business hours, not queued overnight
For the statute behind all of this — Louisiana’s prompt-pay deadline, its Medicaid filing limit, and the wrinkle that catches people out here — see the Louisiana billing page.
Louisiana Medicaid (Healthy Louisiana), in practice
Healthy Louisiana is full comprehensive risk-based managed care — CMS's 2024 file lists six 'Healthy Louisiana (Comprehensive MCO)' plans (Aetna Better Health of Louisiana, AmeriHealth Caritas Louisiana, Healthy Blue, Humana Healthy Horizons, Louisiana Healthcare Connections, UnitedHealthcare Community Plan), plus separate statewide dental PAHPs (DentaQuest, MCNA). UnitedHealthcare's LDH contract was not renewed and expired Dec. 31, 2025 — verbatim from the MCO bulletin: 'The Louisiana Department of Health's (LDH) current contract with the Medicaid managed care organization (MCO) UnitedHealthcare will not be renewed and will expire on December 31, 2025' — leaving five MCOs from Jan. 1, 2026. Source: louisianahealthconnect.com
Louisiana's paper prompt-pay deadline slides based on how fast the provider bills — bill late and you hand the payer an extra 15 days. La. R.S. 22:1832(A)(1) gives contracted providers 45 days from receipt only where the claim was 'submitted by the provider or its agent within forty-five days of the date of service, or date of discharge'; 22:1832(A)(2) stretches that to 'not more than sixty days' for any claim 'submitted by the provider or its agent more than forty-five days after the date of service ... or resubmitted because the original claim was not an accepted claim or not a clean claim.' Every resubmission therefore drops onto the 60-day clock, not the 45-day one. Late payment carries a statutory 12% per annum adjustment (22:1832(C), 22:1833(D)), and the entire subpart expressly does not apply to the Office of Group Benefits, the state employee plan (22:1832(D), 22:1833(E)). Source: FindLaw state code
For enrolment that is not a detail, it is a second application. A carved-out benefit is administered by a different organisation, which credentials separately, on its own timetable, and a provider who is live everywhere else can still be out of network for that one service without anybody noticing until the first claim is denied.
Working Louisiana hours
Louisiana runs on Central time, 11 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 8pm to 4am, and 7pm to 3am once the clocks go forward. Pakistan does not observe daylight saving, so the shift moves on this side rather than yours.
That is the part that decides whether follow-up happens at all: a payer’s phone lines are open on Louisiana hours and nobody else’s.
What it costs in Louisiana
$2,200
Per seat, per month, in US dollars — $26,400 a year for one full-time person, forty hours a week, on Louisiana hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in Louisiana run $1,500 to $2,500; the full list is published.
That is the entire invoice. Run your own figures against a percentage vendor or a hire rather than take ours.
Getting started in Louisiana
About a week from a signed agreement to a person working your queue, and that week of training is not billed on top. The week, step by step, and what is signed before anyone has access.
If working with staff outside the United States is new to your practice, see how a medical billing company structures that seat and why offshore medical billing does not have to mean losing visibility into the work.
Questions
Do you work with Louisiana practices?
Yes. Louisiana accounts are worked during Louisiana office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about Louisiana?
Louisiana expanded Medicaid in 2016 and delivers most of the program through Healthy Louisiana managed care plans, while Blue Cross and Blue Shield of Louisiana remains the dominant commercial carrier.
Which Medicare Administrative Contractor covers Louisiana?
Novitas Solutions, the A/B MAC for jurisdiction JH. It processes Medicare enrollment applications for providers here, and it sends the revalidation notice two to three months before the due date.
When does a Louisiana payer have to pay a clean claim?
25 days for an electronic clean claim (La. R.S. 22:1833(B)(1)). For paper: 45 days if the contracted provider billed within 45 days of the date of service, but 60 days if billed later than that or if the claim is a resubmission (La. R.S. 22:1832(A)(1)-(2)); 45 days for non-contracted providers and member-submitted paper claims (22:1832(A)(3)). It runs from receipt of a clean claim, so claims held back while a provider’s enrollment is pending have not started it.
How often do Louisiana providers have to revalidate?
Medicare: every five years, with sixty days to submit once Novitas sends the notice (42 CFR 424.515). Louisiana Medicaid (Healthy Louisiana): federal rule requires the state to revalidate every provider at least every five years (42 CFR 455.414), and the state agency sets the exact schedule. A Medicare revalidation left unanswered deactivates billing privileges, and claims stop with it.
How much does credentialing cost in Louisiana?
$2,200 per seat per month — $26,400 a year for a full-time person, forty hours a week. Every seat price is published at softhomeglobal.com/pricing.
What hours will somebody actually be working our Louisiana queue?
Louisiana is on Central time, 11 hours behind Rawalpindi. The shift here runs 8pm to 4am so your seat is at a desk for your full working day, shifting to 7pm to 3am while daylight saving is in force — Pakistan does not observe it, so the change happens on our side.
Do you handle Louisiana Medicaid (Healthy Louisiana) as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. Louisiana Medicaid (Healthy Louisiana) has its own submission path, its own filing window and its own appeal route, and working it in the same worklist as commercial claims is how the deadlines get missed.
Is this a percentage of what you collect?
No — a flat monthly rate per seat, published at softhomeglobal.com/pricing. A percentage bills you most in your best month and points the vendor at the easy accounts.
Next step
One seat on your Louisiana work
Twenty minutes on a call is enough to tell whether this fits. If it does not, I will say so.
Or write to ops@softhomeglobal.com