Medical Billing Services in Colorado
Remote medical billing and revenue cycle management for Colorado practices that bill Health First Colorado, Medicare, Medicare Advantage and commercial plans such as Anthem Blue Cross and Blue Shield. Cleaner claims, fewer denials and faster payments, with no upfront cost.
A billing team that knows Colorado payers
Health First Colorado pays most physical-health claims fee-for-service while Regional Accountable Entities coordinate care and behavioral health, so practices often deal with two sets of rules for the same patient. Kaiser Permanente and Anthem are major commercial players along the Front Range.
Provider Concerns handles that work for you, remotely. Our team verifies coverage and plan type before each visit, codes and scrubs every claim, submits it electronically, posts payments and works every denial by reason code. You get a single point of contact and monthly reports on collections, denials and days in A/R, so you always know where your revenue stands.
We work with solo physicians, specialty groups, clinics and multi-location practices across Colorado, including Denver, Colorado Springs, Aurora, Fort Collins, Boulder and Grand Junction. Because we work inside your existing EHR or practice management system, there is nothing to install and no disruption to your front desk. Learn more about our medical billing, denial management, claims processing and revenue cycle management services.
What we handle for Colorado practices
- Medicare Part B claims through Novitas Solutions (Jurisdiction H)
- Health First Colorado claims, through a mix of fee-for-service and managed care
- Medicare Advantage plans, with plan-level authorization tracking
- Commercial payers such as Anthem Blue Cross and Blue Shield, Kaiser Permanente and UnitedHealthcare
- DME claims to CGS (DME Jurisdiction C)
- Eligibility checks, coding review, A/R follow-up and patient statements
- Monthly reporting on collections, denials and days in A/R
Colorado billing rules at a glance
The payer rules that shape how Colorado claims get paid. Plan contracts can differ, so we confirm each payer's current requirements during onboarding.
Medicaid program
Health First Colorado, paid through a mix of fee-for-service and managed care
Medicaid filing limit
Set by the state program and by each managed care plan contract; we confirm every payer's current window during onboarding
Medicare contractor (Part A/B)
Novitas Solutions, Jurisdiction H
Medicare filing limit
12 months (one calendar year) from the date of service
DME contractor
CGS (DME Jurisdiction C)
Major commercial payers
Anthem Blue Cross and Blue Shield, Kaiser Permanente, UnitedHealthcare, Cigna and Rocky Mountain Health Plans
Revenue cycle services for Colorado practices
Pick one service or hand us the whole revenue cycle. Either way, you keep full visibility into every claim.
Medical billing
Charge entry, claim scrubbing and electronic submission to every Colorado payer you work with.
Learn more →Claims processing
Clean claims built to each payer's edits, so fewer are rejected before they are ever reviewed.
Learn more →Denial management
Every denial worked by reason code, corrected, appealed and tracked until it is paid.
Learn more →Revenue cycle management
Eligibility, coding review, payment posting, A/R follow-up and monthly reporting in one service.
Learn more →Common Colorado denials and how we prevent them
Most denials are preventable. These are the ones we see most often for Colorado practices, and the checks we run to stop them before a claim goes out.
Fee-for-service vs. plan confusion
In Colorado, the same Medicaid program can be billed to the state or to a plan. We confirm the right payer before the visit so claims are not denied for going to the wrong place.
Medicare Advantage vs. Original Medicare
Patients move between Original Medicare and Medicare Advantage plans during open enrollment. We verify the plan at every visit so claims don't go to Novitas Solutions when a private plan should be billed.
Missing prior authorization
Many Colorado plans require approval for imaging, procedures and specialty visits. We request and track authorizations before the date of service.
Coding and modifier errors
Bundling edits, missing modifiers and diagnosis codes that don't support medical necessity are among the most common avoidable denials. Certified coders review claims before they go out.
Timely filing
Medicare, Health First Colorado and commercial plans each set different deadlines. We track every open claim against its payer's window so nothing ages out.
Coordination of benefits
Secondary coverage, workers' comp and auto claims need the right payer order. We confirm it up front and bill secondary payers as soon as the primary pays.
Getting started is simple
No long setup and no upfront cost. Here is how Colorado practices move their billing to Provider Concerns.
Free billing review
We look at your collections, denials and A/R to find where revenue is being lost.
Payer setup
We confirm your Health First Colorado, Medicare and commercial enrollments and each payer's rules.
Clean claims
We verify eligibility, code, scrub and submit claims inside your current system.
Follow-up & reports
Denials and aging balances are worked every week, with monthly reporting.
Medical billing across Colorado
We support practices statewide, from large metro groups to rural clinics. Billing is handled online, so location is never a barrier.
Specialties we bill for in Colorado
Frequently asked questions about medical billing in Colorado
Do you bill Health First Colorado?
Who is the Medicare contractor for Colorado?
Which commercial insurance plans do you work with in Colorado?
Can you support practices in Denver and other Colorado cities?
What is the Medicaid timely filing limit in Colorado?
How much does medical billing cost for a Colorado practice?
Ready to get paid faster in Colorado?
Get a free billing review. We'll look at your collections, denials and A/R and show you exactly where revenue is being lost.