Medical Billing in Louisiana

What is specific to Louisiana

Louisiana expanded Medicaid in 2016 and delivers most of the programme through Healthy Louisiana managed care plans, while Blue Cross and Blue Shield of Louisiana remains the dominant commercial carrier.

Louisiana’s Medicaid programme 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.

What a medical billing seat does in Louisiana

Aged accounts receivable called until they close, and denials read, appealed and tracked.

In Louisiana the queue that costs the most is Louisiana Medicaid (Healthy Louisiana), because its filing window and appeal route are not the commercial ones.

• Worklist worked from the difficult end, not the easy end
• Every call logged with the payer reference and the outcome
• Denials categorised so the same reason stops recurring
• Appeals written and submitted, not just re-bills
• Weekly written summary of what moved and what did not
• Worked during Louisiana business hours, not queued overnight

Most of the Louisiana work we see comes out of New Orleans, Baton Rouge and Shreveport, though nothing about a seat depends on where your office is — the queue is worked through your system, not from your building.

Louisiana borders 3 states, and practices near those lines almost always carry at least one out-of-state Medicaid enrollment. That is a separate portal, a separate filing window and a separate appeal route from Louisiana Medicaid (Healthy Louisiana), and it is the queue that most often goes unworked because it belongs to nobody.

What Louisiana law gives you

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)).

Source.

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

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

On the commercial side the dominant Blue plan here trades as Blue Cross and Blue Shield of Louisiana, which since August 2024 markets itself as 'Louisiana Blue'. Verbatim from the Baton Rouge Business Report: 'Blue Cross and Blue Shield of Louisiana on Monday introduced Louisiana Blue, a new brand that CEO Bryan Camerlinck says is aimed at conveying the company's rededication to Louisiana.' The formal name 'Blue Cross and Blue Shield of Louisiana' was still in use in an SEC filing dated 2025-12-10., which matters mainly because its portal and its appeal route are the ones your seat will spend the most time in. Source

We have not been able to source Louisiana’s own Medicaid filing limit from the regulation itself, so this page does not quote one — the federal floor is twelve months from the date of service and a state may set a shorter window. Ask your Louisiana Medicaid (Healthy Louisiana) representative for the figure in writing before you rely on it. The states we could source are listed here.

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

$1,650

Per seat, per month, in US dollars — $19,800 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 $1,450 to $2,400; 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 on your workflow is not billed on top. The work happens in your own system under a login you issue, so there is nothing to migrate and nothing to install. The week, step by step, and what is signed before anyone has access.

Questions