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Radiology Billing Services in Maryland

Maryland nearly lost a Medicaid plan outright: the state announced it would terminate Kaiser Permanente’s HealthChoice contract on September 20, 2024, then reversed course five days later, keeping Kaiser’s 113,000+ members in Maryland’s top-rated Medicaid plan. RBS rebuilt its Maryland process around that near-miss, Jurisdiction L’s six-jurisdiction Medicare rules, and CareFirst’s dominant hold on the commercial market.

Maryland Almost Lost a Medicaid Plan. Has Your Biller Noticed?

Maryland didn’t quietly update a policy, it announced Kaiser Permanente’s HealthChoice contract would end, then reversed that decision five days later. The reversal kept Kaiser’s members covered, but it’s exactly the kind of abrupt change a billing team can miss. Add Jurisdiction L’s six-jurisdiction Medicare footprint and CareFirst’s commercial dominance, and a claim built on outdated assumptions starts breaking fast.

Confirm a HealthChoice MCO's actual contract status, not a stale termination notice

Track Jurisdiction L's Maryland-specific Medicare guidance apart from five sister jurisdictions

Apply Maryland's 30-day clean-claim deadline and 6% annual interest penalty correctly

Keep TC/PC splits accurate against CareFirst's dominant commercial footprint

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 Reasons Maryland Claims Get Denied Now

A Medicaid scare this abrupt hides a lot of ways a clean claim goes sideways. Here’s exactly where it costs you.

Six Jurisdictions, One Medicare Contract

Novitas Solutions runs Jurisdiction L, a Medicare contract covering Delaware, Maryland, New Jersey, Pennsylvania, D.C., and parts of Virginia, a six-jurisdiction mix rather than a Maryland-only operation. Rules built for that wider footprint don’t always fit Maryland’s own claim patterns. RBS reads Jurisdiction L’s Maryland-specific guidance directly, instead of a region-wide default.

Kaiser's HealthChoice Contract Almost Ended

Maryland announced it would terminate Kaiser Permanente’s HealthChoice Medicaid contract on September 20, 2024, then reversed course five days later, keeping Kaiser’s 113,000+ members in the state’s top-rated Medicaid plan. That kind of last-minute reversal is exactly how a billing team gets caught off guard. RBS tracks a HealthChoice MCO’s actual, current contract status, not a stale announcement.

A Second-Try Compact Member Since 2018

Maryland enacted the Interstate Medical Licensure Compact effective July 1, 2018, after an earlier 2016 attempt failed in committee. That later, second-try start leaves Maryland’s compact pipeline newer than some neighbors’. Out-of-state radiologists reading Maryland studies under an expedited license still answer to Maryland’s board rules. RBS verifies compact status before billing out-of-state reads.

One Carrier Dominates, One Interest Rate

CareFirst BlueCross BlueShield controls more than half of most Maryland insurance markets, and up to 70% in some regions, by far the state’s dominant carrier. Maryland’s Insurance Article Section 15-1005 requires clean claims paid within 30 days or 6% annual interest on the balance. Kaiser Permanente, Medicaid’s highest-rated HealthChoice plan, runs entirely separate rules. RBS tracks both.

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 Maryland group navigating a near-miss Medicaid MCO scare, a dominant commercial carrier, and a state where 6.3% of residents still carry no insurance at all (America’s Health Rankings, 2024).

Before RBS

Staffing costs run $60K to $90K a year, hard to justify for a small practice

Denial rates sit at 20 to 35%, often tied to a Medicaid contract scare

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

Manual data entry mistakes cost more than the imaging scan itself

A missed HealthChoice contract reversal sends the claim back unpaid

After RBS

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

98%+ first-pass clean claim rate, checked against active Maryland payers

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 claim billed against Maryland's current MCO roster, not a stale one

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 Baltimore to Bethesda, Billed on Current Facts

A denial in the DC suburbs and a denial on the Eastern Shore rarely share a cause: different referral patterns, different distance to specialists, different local payer mix. RBS bills each Maryland area the way its own provider network actually works, not a single statewide guess.

Baltimore Metro

Cities
  • Baltimore
  • Towson
  • Dundalk
Counties
  • Baltimore County
  • Baltimore City

DC Suburbs

Cities
  • Silver Spring
  • Bethesda
  • Rockville
Counties
  • Montgomery County
  • Prince George's County

Annapolis Area

Cities
  • Annapolis
  • Glen Burnie
  • Pasadena
Counties
  • Anne Arundel County
  • Howard County

Eastern Shore

Cities
  • Salisbury
  • Easton
  • Cambridge
Counties
  • Wicomico County
  • Talbot County

Western Maryland

Cities
  • Hagerstown
  • Frederick
  • Cumberland
Counties
  • Washington County
  • Frederick County

Southern Maryland

Cities
  • Waldorf
  • La Plata
  • Lexington Park
Counties
  • Charles County
  • St. Mary's 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.

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

A claims team working off an old contract notice misses that Kaiser’s HealthChoice termination was reversed within days. Our specialists train on Maryland’s actual, current payer structure, not a generic script, so a stale-contract mismatch is never the reason a claim gets denied.
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Frequently Asked Questions

Which Medicare contractor processes radiology claims in Maryland?

Novitas Solutions, under Jurisdiction L, which also covers Delaware, New Jersey, Pennsylvania, Washington D.C., and parts of Virginia, not Maryland alone.
No. Maryland announced it would end Kaiser Permanente’s HealthChoice contract on September 20, 2024, then reversed the decision five days later, keeping Kaiser’s 113,000+ members covered.
Yes, effective July 1, 2018, after an earlier 2016 attempt failed in committee.
Maryland’s Insurance Article Section 15-1005 requires clean claims to be paid within 30 days or 6% annual interest on the unpaid balance.
Every claim is checked against a HealthChoice MCO’s actual, current contract status, never an outdated termination notice.

Whichever Maryland Office Files It, RBS Gets It Paid

Somewhere in your outstanding claims right now, there’s a clean scan sitting unpaid because it assumed an MCO contract that already reversed, or the wrong side of CareFirst’s dominant commercial share. 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.

Book Your Consultation

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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