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Radiology Billing Services in South Carolina

Built for Palmetto GBA’s four-state Jurisdiction M rules and a Healthy Connections Medicaid program split across five managed care plans, we keep South Carolina radiology groups paid accurately and on time.

Radiology Billing Built For South Carolina's Realities

From the Upstate to the Lowcountry, South Carolina radiology groups bill against a four-state Medicare jurisdiction, a Medicaid program split across five managed care plans, and a prompt pay clock measured in business days.

Jurisdiction M Medicare rules shared with three other states

Five Medicaid managed care plans under one Healthy Connections contract

Not a member of the Interstate Medical Licensure Compact

11.5 percent annual interest on claims paid late

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 %

South Carolina's Regulatory Landscape

South Carolina radiology billing runs through a four-state Medicare jurisdiction, a Medicaid program split across five managed care plans, and a strict business-day prompt pay clock.

Jurisdiction M Medicare Rules

Palmetto GBA processes Medicare Part A and B claims for Jurisdiction M, covering South Carolina, North Carolina, Virginia, and West Virginia. Local coverage determinations are set across all four states, so a policy update out of Virginia applies just as directly to a radiology group in Columbia. We track Palmetto’s specific bulletins so South Carolina claims match the standard actually enforced.

A Medicaid Program Split Five Ways

Healthy Connections Medicaid runs managed care through five plans: Absolute Total Care, Healthy Blue, Humana Healthy Horizons, Molina Healthcare, and Select Health. The current contract runs July 2024 through June 2027, with a second amendment taking effect in July 2025 that adjusted plan requirements. Imaging claims route through whichever plan a patient is enrolled in, each with its own prior authorization rules.

Not a Compact Member

South Carolina has not joined the Interstate Medical Licensure Compact, unlike most states we bill in. An out-of-state radiologist covering a South Carolina hospital or reading remotely for a practice here still needs a full license through the standard Board of Medical Examiners process, with no expedited pathway, before claims can be billed under that provider’s NPI.

20/40-Day Prompt Pay Rule

Under South Carolina Code Title 38, Chapter 59, insurers must pay a clean electronic claim within 20 business days and a paper claim within 40 business days of receiving everything needed to process it. Interest accrues at the state’s legal rate, 11.5 percent annually, starting the 21st or 41st business day. We build South Carolina claims clean on the first pass so they clear inside that window.

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.

Where South Carolina Radiology Billing Breaks Down

A four-state Medicare jurisdiction, a Medicaid program split across five plans, and a steep interest penalty on late claims all add friction most billing teams aren’t built to absorb.

Before RBS

Medicaid claims denied for the wrong plan's prior auth rules

Jurisdiction M denials reworked from scratch every time

Out-of-state radiologists billed under an unlicensed NPI

Paper claims slipping past the 40-business-day deadline

Interest penalties absorbed instead of collected

After RBS

Medicaid claims matched to the correct plan's requirements

Jurisdiction M appeals built on tracked Palmetto bulletins

Licensure confirmed before any claim is ever submitted

Every claim timestamped against the 20/40-day deadline

Late-payment interest tracked and collected, not written off

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

Serving Radiology Practices Across South Carolina

From Columbia and Charleston to Greenville, Myrtle Beach, and the Pee Dee, we bill for radiology groups and their hospital partners across the state.

Midlands & Columbia

Cities
  • Columbia
  • Sumter
  • Camden
Counties
  • Richland County
  • Lexington County

Charleston & the Lowcountry

Cities
  • Charleston
  • North Charleston
  • Summerville
Counties
  • Charleston County
  • Berkeley County

Upstate & Greenville

Cities
  • Greenville
  • Spartanburg
  • Anderson
Counties
  • Greenville County
  • Spartanburg County

Grand Strand & the Pee Dee

Cities
  • Myrtle Beach
  • Florence
  • Conway
Counties
  • Horry County
  • Florence County

CSRA & Aiken

Cities
  • Aiken
  • North Augusta
  • Barnwell
Counties
  • Aiken County
  • Barnwell County

Lowcountry South & Beaufort

Cities
  • Beaufort
  • Hilton Head Island
  • Hardeeville
Counties
  • Beaufort County
  • Jasper 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.

Built for South Carolina's Dominant Private Payer

Blue Cross and Blue Shield of South Carolina holds roughly 59 percent of the state’s commercial health insurance market, more than any other carrier operating here. A practice that can’t bill cleanly against BCBSSC is exposed on the majority of its commercial volume, not just a slice of it. We build every claim to clear its specific requirements the first time, rather than treating it like a generic national payer with generic rules.
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Frequently Asked Questions

What Medicare Administrative Contractor handles South Carolina radiology claims?

Palmetto GBA processes Medicare Part A and B claims for Jurisdiction M, which also covers North Carolina, Virginia, and West Virginia. We track Palmetto’s specific billing bulletins rather than generic national Medicare guidance.
Five: Absolute Total Care, Healthy Blue, Humana Healthy Horizons, Molina Healthcare, and Select Health, under a contract running July 2024 through June 2027. A second amendment took effect in July 2025 that adjusted plan requirements for imaging claims.
No. South Carolina has not joined the Interstate Medical Licensure Compact, unlike most states we bill in. A radiologist covering a South Carolina facility needs a full license from the state’s Board of Medical Examiners before claims can be billed under their NPI.
South Carolina has lost six hospitals since 2010 and faces a projected $150 million in annual Medicaid losses across 60 general hospitals. Act 181, signed in May 2026 after Allendale County Hospital pushed for it, lets rural facilities convert to Rural Emergency Hospital status while keeping their hospital designation under state law.
Yes. BCBSSC covers roughly 59 percent of the state’s commercial insurance market, so most of our clients’ claims run through it. We build claims to its specific requirements rather than treating it as a generic commercial payer.

Get South Carolina Radiology Billing That Keeps Up

From Jurisdiction M appeals to a Medicaid program split five ways, let’s talk about what’s actually slowing down your reimbursements.

Jurisdiction M and Palmetto-specific claim review

Medicaid claims matched to the right managed care plan

Out-of-state licensure confirmed before claims are filed

Clean-claim tracking against the 20/40-business-day deadline

Commercial billing built for BCBSSC's specific requirements

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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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