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Radiology Billing Services in Georgia

Georgia’s Department of Community Health picked four Medicaid managed care plans in December 2024, and two of the state’s three current plans didn’t make the cut. Add a commercial market where one insurer has become the only option across large parts of the state, and a claim built on last year’s payer list can land on a desk that no longer exists. RBS tracks Georgia’s transition as it unfolds, not as it stood before the awards.

Georgia's Medicaid Plans Are Changing. Is Your Billing Ready?

Georgia’s Department of Community Health awarded new Medicaid managed care contracts to CareSource, Humana, Molina Healthcare, and UnitedHealthcare in December 2024, and only CareSource kept its seat. Amerigroup and Peach State Health Plan, two of the state’s three long-standing plans, are being replaced pending unresolved vendor protests. Layer in that Georgia already carries the nation’s fifth-highest uninsured rate, about 1.2 million residents under 65 according to the U.S. Census Bureau, and a CMO switch can mean a coverage gap, not just a paperwork change.

Match every Medicaid claim to the CMO actually holding that member's contract

Track Alliant Health Plans' rules apart from Anthem's much larger footprint

Apply Georgia's 15-working-day prompt pay deadline correctly, every claim

Keep TC/PC splits accurate as Medicaid plan assignments shift underneath you

Processed Claim Value
$ M+
Avg. A/R Collection Time
0 Days
Turn Around Time (TAT)
0 Hours
Client Retention Rate
0 %
Annual Claims
0 M+
First-Pass Claim Rate
0 %
Avg. Revenue Growth
8- 8 %
Avg. Denial Reduction
0 %

Four Ways a Georgia Claim Gets Denied Today

Georgia’s Medicaid overhaul and its shrinking commercial insurer list hide a lot of ways a clean claim goes sideways. Here’s exactly where it costs you.

One Contractor, Three States

Georgia sits inside Jurisdiction J, a Medicare contract shared with Alabama and Tennessee, not a Georgia-only rulebook. Palmetto GBA won this contract in 2024, taking over from the prior administrator. A rule written for a three-state footprint can read differently than one built for Georgia alone. RBS tracks Jurisdiction J on its own, so a shared-contract nuance never gets missed.

A Medicaid Overhaul Mid-Protest

Georgia’s Department of Community Health awarded new Medicaid contracts to CareSource, Humana, Molina, and UnitedHealthcare in December 2024, and only CareSource kept its seat. Amerigroup and Peach State Health Plan, both incumbents, are losing their contracts pending unresolved protests. A claim billed against last year’s plan list can be addressed to a CMO that no longer holds that member.

Established Compact Access Since 2019

Georgia joined the Interstate Medical Licensure Compact in 2019 under Senate Bill 16, giving it roughly seven years of processing history. That’s a longer track record than newer compact members still building their own queues. Out-of-state radiologists shouldn’t assume every compact state moves at the same speed. RBS accounts for Georgia’s established pace, not a newer member’s timeline.

One Insurer, One Prompt-Pay Deadline

Anthem Blue Cross Blue Shield of Georgia has become the only insurer left in large parts of the state’s individual market. Georgia’s prompt pay law, O.C.G.A. Sections 33-24-59.5 and 33-24-59.14, still requires insurers to pay or deny a claim within 15 working days. Alliant Health Plans, a Dalton-based nonprofit carrier, runs separate rules across north Georgia. RBS tracks the deadline and payer differences together.

Complete Radiology Revenue Cycle Management

Certified CIRCC and CPC coders handle every CPT code, modifier, and global billing rule specific to diagnostic and interventional radiology — maximizing reimbursement on every encounter across all modalities and payer types.

What Changes When RBS Takes This Off Your Plate

Radiology billing isn’t generalist RCM. The TC/PC splits, the review clocks, the LCD churn are specialty-specific. Here’s the shift practices see once RBS steps in for a Georgia group navigating a Medicaid overhaul and a commercial market where one insurer keeps expanding its reach.

Before RBS

Staffing costs run $60K to $90K a year, hard to justify in a lean budget

Denial rates sit at 20 to 35%, often just the wrong CMO on file

One staff member's sick day and claims processing grinds to a halt

Manual data entry mistakes cost more than the imaging scan itself

A missed CMO reassignment sends the claim back weeks later, unpaid

After RBS

Performance-based pricing, RBS earns only when your practice collects

98%+ first-pass clean claim rate, checked against the current CMO list

365 days a year, 24/7 revenue cycle coverage, with zero staffing gaps

AI-OCR reads every superbill, EOB, and ERA the moment it arrives

Every Medicaid claim matched to the CMO actually holding it, every time

Precision RCM & Coding Built for Radiology

Generic billing is the fastest way to a denied radiology claim. RBS delivers specialty-specific revenue integrity built for imaging’s TC/PC splits and modifier rules, so you capture every dollar you’re owed.

Diagnostic Radiology

CT Scan

MRI & MRA

Nuclear Medicine

PET / PET-CT

Ultrasound

Interventional Radiology

Teleradiology

Mammography

DEXA / Bone Density

Hospital Radiology

Radiation Oncology

Coverage Confirmed for Every Payer You Work With

From national carriers to regional Medicaid plans, coverage is checked against the exact payer, plan, and product type on file — never a generic match. Every result reflects current payer policy, not outdated data from months ago.
medicare
Medicaid
Molina health
Ambetter health
cigna
Elevance Health (Anthem)
United healthcare
aetna
Blue cross Blue shield
OSCAR health
Health Net
Kaiser Permanente
tricare
wellcare
Humana
medicare
Medicaid
Molina health
Ambetter health
cigna
Elevance Health (Anthem)
United healthcare
aetna
Blue cross Blue shield
OSCAR health
Health Net
Kaiser Permanente
tricare
wellcare
Humana
medicare
Medicaid
Molina health
Ambetter health
cigna
Elevance Health (Anthem)
United healthcare
aetna
Blue cross Blue shield
OSCAR health
Health Net
Kaiser Permanente
tricare
wellcare
Humana

From Metro Atlanta to the Coast, Billed on Current Facts

A denial in Atlanta and a denial in Savannah rarely share a cause: different CMO assignment, different payer mix, different distance to specialists. RBS bills each Georgia area as the payer list stands today, not as it stood before the 2024 contract awards.

Atlanta Metro

Cities
  • Atlanta
  • Sandy Springs
  • Marietta
  • Alpharetta
  • Decatur
  • Duluth
Counties
  • Fulton County
  • DeKalb County
  • Cobb County
  • Gwinnett County

Augusta & the CSRA

Cities
  • Augusta
  • Evans
  • Martinez
  • Grovetown
  • Thomson
  • Waynesboro
Counties
  • Richmond County
  • Columbia County
  • McDuffie County
  • Burke County

Columbus & West Georgia

Cities
  • Columbus
  • LaGrange
  • Carrollton
  • Newnan
  • West Point
  • Villa Rica
Counties
  • Muscogee County
  • Troup County
  • Coweta County
  • Carroll County

Macon & Middle Georgia

Cities
  • Macon
  • Warner Robins
  • Perry
  • Centerville
  • Milledgeville
  • Forsyth
Counties
  • Bibb County
  • Houston County
  • Baldwin County
  • Monroe County

Savannah & Coastal Georgia

Cities
  • Savannah
  • Pooler
  • Tybee Island
  • Richmond Hill
  • Statesboro
  • Brunswick
Counties
  • Chatham County
  • Bryan County
  • Bulloch County
  • Glynn County

Athens & Northeast Georgia

Cities
  • Athens
  • Gainesville
  • Oakwood
  • Winder
  • Commerce
  • Jefferson
Counties
  • Athens-Clarke County
  • Hall County
  • Barrow County
  • Jackson County

Wired Into Every System You Already Run

Your EHR, RIS, and PACS stay exactly as they are. We plug our coding workflow directly into what you already use — no migration, no new login for your radiologists, no disruption to how your team already works.

Georgia Runs on Rules Built for Georgia. So Does Every Other State We Bill.

A claims team working off last year’s CMO list misses a Medicaid overhaul Georgia itself set in motion in December 2024, and the gap between Anthem’s growing footprint and Alliant Health Plans’ separate rulebook. Our specialists train on Georgia’s actual, current payer structure, not a generic script, so a stale CMO assignment is never the reason a claim gets denied.
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Frequently Asked Questions

Which Medicare contractor processes radiology claims in Georgia?

Palmetto GBA, under Jurisdiction J, which also covers Alabama and Tennessee rather than Georgia alone.
RBS checks the current plan assignment at the time of service and resubmits to the correct CMO, so a mid-treatment switch doesn’t strand a claim with a plan that no longer covers that patient.
No. Alliant Health Plans is a nonprofit carrier based in Dalton with its own separate rules for its north Georgia service area, distinct from Anthem’s much larger statewide footprint.
Since 2019, when the state joined the Interstate Medical Licensure Compact under Senate Bill 16, giving it roughly seven years of processing history.
Every claim is matched to the CMO actually holding that member’s contract at the time of service, not the plan list from before the December 2024 contract awards.

Whichever Georgia Office Files It, RBS Gets It Paid

Somewhere in your outstanding claims right now, there’s a clean scan sitting unpaid because it was billed against a CMO that’s losing its contract or the wrong side of Georgia’s shrinking commercial market. Across the practices we review, that adds up to 5 to 10% of collectible revenue, aging quietly by the day. RBS finds it, recovers it, and builds a process that stops it from recurring. Start with a free audit, no commitment, just a clear answer on what’s actually recoverable before you decide anything.

No setup fee. No monthly minimum.

Cancel anytime.

Response within 24 hours.

Pay only a percentage of what we collect for you

Free claims and A/R audit before you commit to anything.

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What Our Clients Say?

Rebecca Lawson

★★★★★

Radiology Practice Manager

Since partnering with your radiology billing team, our billing workflow has become much smoother. They understand imaging procedures, payer requirements, coding, and claim follow-ups. Their team is responsive, professional, and always stays on top of outstanding claims.

Dr. Christopher Bennett

★★★★★

Medical Director, Diagnostic Imaging Center

Your team truly understands the challenges of radiology billing. They handle claims accurately, follow up on unpaid accounts, and help resolve billing issues efficiently. Their expertise and communication have made our revenue cycle more organized and reliable.

Dr. Andrew Whitaker

★★★★★

Radiologist & Imaging Center Owner

Our team has been an excellent partner for our imaging center. They understand radiology billing, coding, claim submission, denials, and follow-ups. Their attention to detail and consistent communication have helped streamline our billing process and improve our revenue cycle.

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