- info@swiftcarebilling.com
- (848) 359-5702
- 525 NJ-73 STE 104 MARLTON, NEW JERSEY 08053
We turn billing headaches into steady cash flow. Healthcare in Massachusetts is among the most advanced in the country—but so are the billing challenges. With a complex payer mix (including Blue Cross Blue Shield of Massachusetts, Tufts Health, Harvard Pilgrim, Fallon, MassHealth, and Medicare Advantage), staying compliant and profitable can overwhelm even experienced in-house teams. That’s where Swiftcare steps in.
Billing in Massachusetts isn’t just about coding correctly—it’s about keeping up with layers of payer rules, compliance updates, and ever-changing Medicaid policies. Every provider, from Boston hospitals to small clinics in Worcester, faces unique hurdles that make revenue cycle management a constant balancing act:
Strict prior authorization requirements, bundled services, and frequent rule updates can derail claims if you’re not vigilant.
Commercial payers, including Blue Cross Blue Shield of Massachusetts, Tufts, and Harvard Pilgrim, all enforce unique coding, filing, and appeal processes that differ from national standards.
With high penetration across Boston and suburban areas, accurate risk-adjustment coding is critical for steady reimbursements.
Massachusetts enforces strict balance billing and transparency requirements, making compliance non-negotiable.
With staffing shortages and rising overhead, many practices can’t afford to waste time on manual billing. Outsourcing has become the smarter option.
Fact: More than 65% of Massachusetts practices outsource part of their billing to reduce denials and stabilize cash flow.
At Swiftcare, we combine local payer expertise with national resources, providing Massachusetts providers with a partner who truly understands their billing environment. Here’s what that looks like in action:
We prevent revenue leakage by addressing coding and documentation issues before claims are submitted.
Same-day filing and real-time tracking keep cash flowing faster.
Even with strict MassHealth rules, we consistently submit claims that get approved the first time.
Our processes are aligned with Massachusetts billing laws and audit requirements, ensuring you stay fully protected.
We deliver actionable insights—AR aging, denial trends, and payer-specific KPIs—so you always know where your revenue stands.
Here’s what you can expect with Swiftcare:
We confirm coverage for MassHealth, Medicare, and commercial plans. That means no treatment surprises or post-service denials.
Our team handles approvals quickly for imaging, specialty meds, and high-cost procedures. With BCBSMA and Tufts, precision is key to timely payments.
Certified coders review charts against Massachusetts payer rules. This reduces audit risk while capturing every eligible dollar.
We file claims the same day services are provided. Real-time tracking keeps claims moving and reduces AR delays.
Every payment is posted and matched against expected reimbursements. Underpayments are flagged instantly for recovery.
We don’t accept denials as lost revenue. With payer-specific appeal strategies, we overturn 80%+ of denied claims.
We design patient-friendly statements and online portals that are easy to understand. Collections fully comply with Massachusetts debt-collection laws.
Transparent dashboards show denial trends, AR aging, and payer performance. Providers can view their financial health in real-time.
We work with providers across the Commonwealth:
In Massachusetts, where providers juggle MassHealth, BCBSMA, Tufts, and Medicare Advantage billing, the right technology isn’t just a convenience—it’s survival. At Swiftcare, we don’t just “work with” systems—we optimize them so your staff spends less time chasing claims and more time on patients. We connect with nearly all major platforms, ensuring smooth workflows and minimal disruption:
Most national billing companies take a “one-size-fits-all” approach. Swiftcare wins because we:
From MassHealth to Medicare Advantage, we turn billing chaos into predictable revenue.”
Our Massachusetts billing experts cut denials, speed up reimbursements, and keep your practice compliant with the state’s strict payer and audit rules. Real results, usually in 60–90 days.”
Yes. We specialize in MassHealth’s strict prior authorization workflows, carve-outs, and bundled payment rules. Our system flags authorization needs before a claim is filed, preventing the denials that frustrate many Massachusetts providers.
