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Radiology Billing Services in Nebraska

Built for WPS Government Health Administrators’ Jurisdiction 5 rules and a Medicaid program run through three statewide Heritage Health plans, we keep Nebraska radiology groups paid accurately and on time.

Radiology Billing Built Around Nebraska's Realities

From Omaha to the Panhandle, Nebraska radiology groups bill against a four-state Medicare jurisdiction, a Medicaid lineup that changed plans in 2024, and 62 critical access hospitals.

Jurisdiction 5 Medicare rules shared with Iowa, Kansas, and Missouri

Three Heritage Health MCOs, with one incumbent replaced in 2024

62 critical access hospitals spread across a vast rural footprint

Compact licensure that speeds, but doesn't skip, credentialing

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 Shapes Nebraska Radiology Claims

Four forces define how radiology claims get paid in Nebraska: the Medicare jurisdiction, the Heritage Health lineup, compact licensure, and state prompt-pay law.

Jurisdiction 5 Medicare Rules

WPS Government Health Administrators runs Medicare Part A and B claims for Jurisdiction 5, covering Iowa, Kansas, Missouri, and Nebraska. Coverage determinations and appeals timelines are set jurisdiction-wide, so a denial pattern surfacing in Kansas can show up in Omaha just as easily. We track WPS’s specific LCDs and billing bulletins so Nebraska claims match the standard actually enforced.

Heritage Health's 2024 Lineup

Nebraska’s integrated Heritage Health Medicaid program, covering roughly 347,000 people, moved to new contracts on January 1, 2024: Molina Healthcare of Nebraska, Nebraska Total Care, and UnitedHealthcare Community Plan of the Midlands. Healthy Blue, the prior incumbent, lost its contract and protested unsuccessfully. A claim’s prior-auth rules and dental benefits now depend on getting the current three-plan lineup right.

A Compact State, Not a Skip

Nebraska joined the Interstate Medical Licensure Compact in 2017 as its 19th member, so an out-of-state radiologist can get a Nebraska license faster than in a non-compact state. Faster isn’t instant, though: the compact still requires a separate license and enrollment before claims can be billed under that radiologist’s NPI, so credentialing timelines still need to be built into coverage planning.

30/45-Day Prompt Pay Act

Nebraska’s Health Care Prompt Payment Act, Neb. Rev. Stat. §§ 44-8001 to 44-8010, requires insurers to settle clean claims within 30 calendar days electronically or 45 days on paper, with interest owed on anything paid late. An insurer can only skip that interest by filing a compliance statement with the state by December 1 each year. We build Nebraska 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 Nebraska Radiology Billing Breaks Down

A Medicaid lineup that just changed, compact licensing that still needs follow-through, and a huge critical access hospital network all add friction most billing teams aren’t built to absorb.

Before RBS

Claims still routed to Healthy Blue after its 2024 contract loss

Jurisdiction 5 denials reworked from scratch every single time

Compact licensing mistaken for coverage, stalling new claims

Critical access hospital partners absorbing avoidable denials

Clean claims quietly missing the state's 30/45-day deadline

After RBS

Eligibility and prior-auth rebuilt around the current Heritage Health plans

Jurisdiction 5 appeals built on tracked WPS coverage patterns

Compact licensing and payer enrollment tracked as two separate steps

Critical access hospital partners billing on margins that hold up

Every clean claim timestamped and chased before its deadline passes

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 Nebraska

From the Omaha and Lincoln metros to the Panhandle and the Sandhills, we bill for radiology groups and their hospital partners across the state.

Omaha Metro

Cities
  • Omaha
  • Bellevue
  • Papillion
Counties
  • Douglas County
  • Sarpy County

Lincoln & Southeast Nebraska

Cities
  • Lincoln
  • Beatrice
  • Nebraska City
Counties
  • Lancaster County
  • Gage County

Central Nebraska

Cities
  • Grand Island
  • Kearney
  • Hastings
Counties
  • Hall County
  • Buffalo County

Panhandle

Cities
  • Scottsbluff
  • Gering
  • Alliance
Counties
  • Scotts Bluff County
  • Box Butte County

North Central & the Sandhills

Cities
  • North Platte
  • Valentine
  • Ogallala
Counties
  • Lincoln County
  • Cherry County

Northeast Nebraska

Cities
  • Norfolk
  • Columbus
  • South Sioux City
Counties
  • Madison County
  • Dakota 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 to Handle Nebraska's Dominant Payer

Blue Cross Blue Shield of Nebraska is the state’s dominant carrier, even after exiting the ACA exchange following more than $140 million in losses there, a move that affected roughly 20,000 individual plans while leaving its much larger group business untouched. A practice that can’t bill cleanly against BCBS Nebraska is exposed on most of its commercial volume. We build every claim to clear its requirements the first time.
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Frequently Asked Questions

What Medicare Administrative Contractor handles Nebraska radiology claims?

WPS Government Health Administrators administers Medicare Part A and B claims for Jurisdiction 5, which covers Nebraska along with Iowa, Kansas, and Missouri. We track WPS’s specific billing bulletins rather than generic national Medicare guidance.
Heritage Health runs through Molina Healthcare of Nebraska, Nebraska Total Care, and UnitedHealthcare Community Plan of the Midlands, effective since January 1, 2024. Healthy Blue, the prior incumbent, lost its contract and is no longer one of the three plans.
No. Nebraska joined the Interstate Medical Licensure Compact in 2017, which speeds up getting a Nebraska medical license, but an out-of-state radiologist still needs that license and separate payer enrollment before claims can be billed under their NPI.
Nebraska has 62 federally designated critical access hospitals spread across a large rural footprint. That hospital network depends on clean, accurately paid radiology claims, with very little room for denials or slow appeals to go unchallenged.
Yes. BCBS Nebraska is the state’s dominant insurer for employer-based coverage, so most of our clients’ commercial claims run through it. We build claims to its specific requirements rather than treating it as a generic commercial payer.

Get Nebraska Radiology Billing That Keeps Up

From Jurisdiction 5 appeals to the current Heritage Health lineup, let’s talk about what’s actually slowing down your reimbursements.

Jurisdiction 5 and WPS-specific claim review

Medicaid eligibility rebuilt for Molina, Nebraska Total Care, and UHC

Compact licensing and payer enrollment tracked end to end

Clean-claim tracking against the 30/45-day statutory deadline

Critical access hospital billing built for thin rural margins

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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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