Reliable Medical billing services in Maryland
SwiftCare Billing provides medical billing services in Maryland for practices that are tired of chasing payers. We bill Novitas Solutions for Medicare, all nine HealthChoice Medicaid plans, and CareFirst BlueCross BlueShield. Pricing starts at 3% of collections. Month-to-month, 30 days’ notice.
- 98.4% Clean Claim Rate
- 175+ Providers
- 50+ Specialties
- 12+ Years
Maryland medical billing at a glance
| Item | Maryland |
|---|---|
| Medicaid program | Maryland Medicaid is administered by the Maryland Department of Health (MDH) and is called HealthChoice in managed care. |
| Medicaid enrollment | About 1.49 million in April 2026 |
| HealthChoice plans | Aetna Better Health of Maryland, UnitedHealthcare Community Plan, CareFirst Community Health Plan Maryland, Jai Medical Systems, Kaiser Permanente, MedStar Family Choice, Maryland Physicians Care, Priority Partners, Wellpoint Maryland |
| Medicaid provider enrollment | ePREP (eprep.health.maryland.gov) |
| Medicare A/B contractor | Novitas Solutions, Jurisdiction L (also Delaware, DC, New Jersey, Pennsylvania) |
| Medicare DME contractor | DME MAC Jurisdiction A |
| Medicare timely filing | 12 months from date of service |
| Medicaid plan timely filing | Varies by plan; Wellpoint allows 180 days (confirm each plan's manual) |
| Commercial prompt pay | 30 days from a clean claim, interest if late (Insurance Article 15-1005) |
| Surprise billing | State law for hospital-based and on-call physicians (14-205.2), plus the federal No Surprises Act |
| Workers' compensation | Maryland Workers' Compensation Commission medical fee guide (COMAR 14.09.03) |
| Auto accident claims | At-fault state; insurers must offer PIP, minimum $2,500 |
Why billing in Maryland takes state-specific work?
Nine Medicaid plans, and members move between them
Most Maryland Medicaid patients are in HealthChoice, and they can change plans. Those who don’t choose get auto-assigned. Prince George’s County alone has about 254,000 members, and Baltimore City about 244,000. A claim to the wrong plan just bounces. We check the plan on the date of service, every visit.
Maryland's prompt pay law has teeth, and it changed in 2026
Carriers must pay a clean claim within 30 days or tell you why not, and late payments accrue interest. It covers Medicaid plans too. Does not cover Medicare, self funded employer plans, PIP or workers comp. HB 739, which passed in April 2026, tightens the way carriers send those notices.
Surprise billing follows two rule books
Maryland’s own law sets payment for hospital-based and on-call physicians at in-network rates. Other out-of-network doctors can collect usual charges from patients, but only with proper disclosure. The federal No Surprises Act sits on top. We sort each claim by which rule applies.
Workers' comp and PIP pay on different logic
Workers’ comp follows the Commission’s fee guide. PIP is optional, and the minimum is just $2,500, so it runs out fast. Chiropractic and physical therapy practices see this daily. We track the limit and bill the next payer in line.
- Our Services
Our medical billing services in Maryland
Our Maryland medical billing services cover the full healthcare revenue cycle management process, or any step of it. That includes medical billing and coding services from AAPC-certified coders, built for outsourced medical billing for Maryland clinics and private groups.
We confirm which of the nine plans a patient is on, not just that Medicaid is active
Codes checked against Novitas edits and each plan’s rules
Claim submission
Claims scrubbed first, tracked until paid
Each denial logged by payer and reason, then the cause fixed
Claims past day 30 get chased, with interest owed where the law says so
Payments posted, statements patients can actually read
Requests tracked plan by plan
Medical credentialing and payer enrollment in Maryland
You can’t bill until you’re enrolled. In Maryland Medicaid, providers register through ePREP, then join each HealthChoice plan on its own. Maryland also has a credentialing law of its own for commercial carriers (Insurance Article 15-112). Our medical credentialing services cover all of it.
- NPI check and an attested CAQH profile
- Medicare enrollment through PECOS, processed by Novitas
- Medicaid registration in ePREP
- Credentialing with each HealthChoice plan you choose
- Commercial plan applications, including CareFirst
- Revalidation reminders
Payers we bill in Maryland
We bill Medicare, Medicare Advantage, Medicaid plans and commercial carriers like CareFirst BlueCross BlueShield. Workers’ comp and PIP carriers are on the list too. For a view of how vendors stack up, see how to compare medical billing companies in Maryland.
Medical specialties we bill for in Maryland
We bill 50+ specialties. Maryland practices often come to us in family practice, pediatrics, mental health, physical therapy, chiropractic and cardiology.
EHR and practice management systems we work with
We support 80+ systems and work inside yours: Epic, athenahealth, eClinicalWorks, Tebra (Kareo) and AdvancedMD, among others. Nothing to migrate. We connect to your clearinghouse and the ePREP portal.
Where we work in Maryland
Baltimore, Columbia, Silver Spring, Rockville, Frederick, Annapolis, Bethesda, Towson, Salisbury and Hagerstown, and the towns in between. SwiftCare Billing serves providers in all 50 states.
Medical billing services in Baltimore, Maryland for private practices
Baltimore City has about 244,000 Medicaid members, so plan-level billing matters here. Small private practices in the city get a named account manager and monthly reports.
HIPAA-compliant medical billing services in Maryland
Billing means handling patient data all day. Here’s what you should expect from any vendor, us included.
- A signed BAA. Under HIPAA, you need a business associate agreement before a vendor touches your PHI (45 CFR 164.504(e)). We sign one first.
- Notice of Breach. A business associate must notify you of breach without unreasonable delay and no later than 60 days after discovery (45 CFR 164.410). Your BAA may specify a shorter date and we will adhere to that.
- Restricted access. Our billing professionals in the U.S. know what a billing task requires, not the entire chart.
- Your data stays yours. If you leave, your claims and patient accounts go with you.
Maryland also has its own medical records confidentiality law.
Results Maryland practices can check
98.4% clean claim rate across SwiftCare Billing clients
Onboarding in 7 to 14 business days
Free audit report in 5 business days
Affordable medical billing services in Maryland
Pricing starts at 3% of collections. Most practices land between 3% and 8%, depending on specialty, volume and payer mix. No long-term contract. Small practices start with a free audit, so they see numbers in detail before they commit to anything.
How onboarding works
1. Free audit of your recent claims, written report in 5 business days
2. Access to your EHR and clearinghouse
3. Enrollment check with Novitas, Maryland Medicaid and each plan you bill
4. Fee schedule and contract review
5. Go-live in 7 to 14 business days, then monthly reporting
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Frequently asked questions about medical billing in Maryland
How much does medical billing cost in Maryland?
It starts at 3% of collections. Most practices pay 3% to 8%. A free audit gives you a quote based on your own claims, not a guess.
Which Maryland Medicaid plans do you bill?
All nine HealthChoice plans, from Aetna Better Health of Maryland to Wellpoint Maryland. We also handle credentialing with each one.
Who processes Medicare claims in Maryland?
Novitas Solutions, as the A/B MAC for Jurisdiction L, DME claims go to DME MAC Jurisdiction A. Medicare claims must be filed within 12 months.
How fast must Maryland insurers pay?
Within 30 days of receiving a clean claim, a carrier must pay it or send notice saying why not. Late payments accrue interest. Medicare and self-funded plans aren’t covered by this law.
Does Maryland have its own surprise billing rules?
Yes. State law covers hospital-based and on-call physicians, and the federal No Surprises Act applies too. We identify which rules fit each claim and prepare the paperwork.
Do you sign a business associate agreement?
Yes, before we access anything. HIPAA requires it, and it sets breach-notice terms.
Can you work inside our EHR?
Yes. We support 80+ systems, and you keep yours.
Talk to a billing team that knows Maryland Medicaid
Tell us which HealthChoice plans and commercial payers you bill. We’ll review your recent claims and send a written report within 5 business days.