Vermont flag

Radiology Billing Services in Vermont

Built for National Government Services’ seven-state Jurisdiction K rules and Vermont’s uniquely structured Global Commitment Medicaid waiver, we keep Vermont radiology groups paid accurately and on time.

Radiology Billing Built For Vermont's Realities

From Burlington to the Northeast Kingdom, Vermont radiology groups bill against a seven-state Medicare jurisdiction, a Medicaid program run under its own federal waiver, and a dominant private payer that nearly collapsed just last year.

Jurisdiction K Medicare rules shared with six other states

Medicaid run under Vermont's own Global Commitment waiver

30-day prompt pay standard backed by 12 percent interest

Compact-licensed physicians accepted since 2018

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 %

What Makes Vermont Radiology Billing Different

Four regulatory layers shape every claim we file for Vermont radiology practices.

Jurisdiction K Medicare Rules

National Government Services processes Medicare Part A and B claims for Jurisdiction K, covering Vermont, Connecticut, Maine, Massachusetts, New Hampshire, New York, and Rhode Island. A coverage update out of New York applies just as directly to a radiology group in Burlington. We track NGS’s specific bulletins so Vermont claims match the standard actually enforced across all seven states.

A State-Run Medicaid Waiver

Vermont runs Medicaid under its Global Commitment to Health, a federal Section 1115 waiver that lets the state act as its own managed care entity rather than contracting out to private MCOs the way most states do. That structure keeps policy decisions concentrated in Montpelier, but it also means national MCO billing playbooks from other states don’t transfer directly to a Vermont claim.

A 2018 Compact Member

Vermont joined the Interstate Medical Licensure Compact in 2018 under Act 115, letting physicians already licensed in a member state fast-track a Vermont license. The compact speeds up credentialing, but a separate payer enrollment is still required before claims can be billed under that radiologist’s NPI, a step that still catches practices off guard.

30-Day Prompt Pay Standard

Vermont’s prompt payment standard requires insurers to pay a clean claim within 30 days, with claims paid beyond that window qualifying for 12 percent interest for the duration of the delay. That standard came under real strain in 2019, when a payment system failure at Vermont’s largest insurer triggered state regulatory monitoring. We build Vermont 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 Vermont Radiology Billing Breaks Down

A seven-state Medicare jurisdiction, a Medicaid program run on its own state waiver, and a dominant private payer working through years of financial strain all add friction most billing teams aren’t built to absorb.

Before RBS

Medicaid claims billed like a private-MCO state, not a waiver state

Jurisdiction K denials reworked from scratch every time

Compact licensing mistaken for payer enrollment

Clean claims slipping past the 30-day deadline

12 percent interest penalties absorbed instead of collected

After RBS

Medicaid claims billed to Vermont's actual waiver structure

Jurisdiction K appeals built on tracked NGS bulletins

Licensure and payer enrollment tracked as two separate steps

Every clean claim timestamped against the 30-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 Vermont

From Burlington and Montpelier to Rutland, Brattleboro, and the Northeast Kingdom, we bill for radiology groups and their hospital partners across the state.

Burlington & Chittenden County

Cities
  • Burlington
  • South Burlington
  • Essex
Counties
  • Chittenden County

Montpelier & Central Vermont

Cities
  • Montpelier
  • Barre
  • Waterbury
Counties
  • Washington County

Rutland & the Southwest

Cities
  • Rutland
  • Brandon
  • Fair Haven
Counties
  • Rutland County

Brattleboro & Southeastern Vermont

Cities
  • Brattleboro
  • Bellows Falls
  • Springfield
Counties
  • Windham County

St. Johnsbury & the Northeast Kingdom

Cities
  • St. Johnsbury
  • Newport
  • Lyndonville
Counties
  • Caledonia County
  • Orleans County

Middlebury & Addison County

Cities
  • Middlebury
  • Vergennes
  • Bristol
Counties
  • Addison 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 Vermont's Recovering Dominant Payer

BlueCross BlueShield of Vermont covers roughly 230,000 Vermonters, about a third of the state, making it Vermont’s largest insurer by far. The carrier lost nearly $150 million from 2021 through 2024 and leaned on an emergency loan before posting a $53 million operating gain in 2025, its first profitable year since 2020. A practice that can’t bill cleanly against BCBSVT is exposed to whichever phase of that recovery it’s in.
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Frequently Asked Questions

What Medicare Administrative Contractor handles Vermont radiology claims?

National Government Services processes Medicare Part A and B claims for Jurisdiction K, which also covers Connecticut, Maine, Massachusetts, New Hampshire, New York, and Rhode Island. We track NGS’s specific billing bulletins rather than generic national Medicare guidance.
Vermont runs Medicaid under its Global Commitment to Health, a federal Section 1115 waiver that makes the state itself the managed care entity instead of contracting the work out to private MCOs. Billing playbooks built around another state’s MCO contracts don’t transfer directly to a Vermont claim.
No. Vermont joined the Interstate Medical Licensure Compact in 2018 under Act 115, which speeds up getting a Vermont medical license, but an out-of-state radiologist still needs that license and separate payer enrollment before claims can be billed under their NPI.
Vermont’s prompt payment standard calls for payment within 30 days, with claims paid beyond that window qualifying for 12 percent interest for the duration of the delay. We track every claim’s clock so that interest gets collected instead of waived.
Yes. BCBSVT covers roughly a third of Vermont’s population and is in the middle of a multi-year financial recovery after nearly $150 million in losses. We build claims to its specific requirements rather than treating it as a generic commercial payer.

Get Vermont Radiology Billing That Keeps Up

From Jurisdiction K appeals to a Medicaid program run on its own state waiver, let’s talk about what’s actually slowing down your reimbursements.

Jurisdiction K and NGS-specific claim review

Medicaid claims billed to Vermont's actual waiver structure

Compact licensing and payer enrollment tracked end to end

Clean-claim tracking against the 30-day deadline

Commercial billing built for BCBSVT'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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