Medical Billing in Wyoming
Soft Home Global provides billing, AR follow-up and denial appeals for Wyoming practices and billing companies at $1,700 per seat per month. Full time, worked during Wyoming business hours, inside your own system.
What is specific to Wyoming
Wyoming runs Medicaid mainly on a fee-for-service basis rather than through managed care organizations, has not adopted expansion, and its small commercial market is led by Blue Cross Blue Shield of Wyoming.
Wyoming’s Medicaid programme is Wyoming Medicaid. Practices with a meaningful Wyoming Medicaid 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 Wyoming
Aged accounts receivable called until they close, and denials read, appealed and tracked.
In Wyoming the queue that costs the most is Wyoming Medicaid, 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 Wyoming business hours, not queued overnight
Most of the Wyoming work we see comes out of Cheyenne, Casper and Laramie, though nothing about a seat depends on where your office is — the queue is worked through your system, not from your building.
Wyoming borders 6 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 Wyoming Medicaid, and it is the queue that most often goes unworked because it belongs to nobody.
What Wyoming law gives you
45 days after receipt of the proofs of loss and supporting evidence. No electronic vs paper distinction in the statute. Exception: accident and health claims where validity or amount is questioned and referred to the Wyoming state medical peer review committee.
Wyoming Medicaid, in practice
Fee-for-service statewide with no comprehensive Medicaid MCOs (KFF 2024 MCO enrollment = N/A; "N/A: Not applicable. State had no contracts with comprehensive MCOs."); claims are processed by fiscal agent Acentra Health on behalf of the Wyoming Department of Health, Division of Healthcare Financing. Source
Wyoming Medicaid actively restricts out-of-state care, which matters because most Wyoming patients live near a border: "If services are available in Wyoming within a reasonable distance from the Member's home, the Member must not utilize an out-of-state Provider," and an out-of-state, non-enrolled provider "may choose to enroll in the Medicaid Program and submit the claim according to Medicaid billing instructions or bill the Member." Timely filing is a strict 12 months (365 days) from date of service; Medicare crossovers get 12 months from DOS or 180 days from the EOMB payment date, whichever is later. Source
On the commercial side the dominant Blue plan here trades as Blue Cross Blue Shield of Wyoming, 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 Wyoming’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 Wyoming Medicaid representative for the figure in writing before you rely on it. The states we could source are listed here.
Working Wyoming hours
Wyoming runs on Mountain time, 12 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 9pm to 5am, and 8pm to 4am 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 Wyoming hours and nobody else’s.
What it costs in Wyoming
$1,700
Per seat, per month, in US dollars — $20,400 a year for one full-time person, forty hours a week, on Wyoming hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in Wyoming 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 Wyoming
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
Do you work with Wyoming practices?
Yes. Wyoming accounts are worked during Wyoming office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about Wyoming?
Wyoming runs Medicaid mainly on a fee-for-service basis rather than through managed care organizations, has not adopted expansion, and its small commercial market is led by Blue Cross Blue Shield of Wyoming.
When does a Wyoming payer have to pay a clean claim?
45 days after receipt of the proofs of loss and supporting evidence. No electronic vs paper distinction in the statute. Exception: accident and health claims where validity or amount is questioned and referred to the Wyoming state medical peer review committee. A claim sitting past that is not merely late, it is late against a statute, and the follow-up call changes from "when might this be paid" to "this passed your statutory window on a specific date".
How much does medical billing cost in Wyoming?
$1,700 per seat per month — $20,400 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 Wyoming queue?
Wyoming is on Mountain time, 12 hours behind Rawalpindi. The shift here runs 9pm to 5am so your seat is at a desk for your full working day, shifting to 8pm to 4am while daylight saving is in force — Pakistan does not observe it, so the change happens on our side.
Do you handle Wyoming Medicaid as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. Wyoming Medicaid 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.
What is the minimum commitment, and how quickly can somebody start?
One seat for one month, cancellable on thirty days notice, and about a week from a signed agreement to a person working your queue. The week of training is not billed. The steps are at softhomeglobal.com/how-it-works.
Is our patient data safe offshore?
A Business Associate Agreement is signed before anyone has access, and the work happens in your own system under a login you issue, so every action is attributable to a person in your audit trail. The controls are listed at softhomeglobal.com/security.
Next step
One seat on your Wyoming 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