Medical Billing Services in West Virginia
West Virginia carries one of the highest Medicaid enrollment shares in the country — expansion plus demographics make Medicaid the structural payer for much of the state — with members across MCOs including Aetna Better Health, The Health Plan (the Wheeling-grown provider-affiliated carrier) and UniCare (Wellpoint), over a commonly published 365-day state window. Highmark BCBS West Virginia is the Blue, PEIA (the public employees' agency) is a payer class of its own given the state's public workforce, and WVU Medicine's expansion has consolidated care across the state's hollows and valleys.
West Virginia Medicaid / Mountain Health Trust: filing rules that decide whether you get paid
Administered by the WV Bureau for Medical Services
West Virginia Medicaid places most members in managed care under the Mountain Health Trust program — Aetna Better Health, The Health Plan and UniCare among the carriers — whose manuals set working limits under a commonly published state window of 365 days. Expansion made coverage broad, and the state's demographics make Medicaid — alongside Medicare — the volume engine for most practices; behavioral health and SUD services carry outsized share here, with West Virginia's treatment infrastructure billing rules a daily specialty rather than a niche.
Deadlines for every major payer — including West Virginia Medicaid — live in our timely filing limits tool, with an interactive deadline checker.
The payers we bill every day in West Virginia
West Virginia billing rules that move real money
Medicaid as the structural payer
With one of the nation's highest Medicaid shares, West Virginia practices are Medicaid practices by construction — MCO manual fluency, SUD/BH billing rules and eligibility churn management aren't specialties here, they're the core competency.
PEIA's own world
PEIA covers the state's public workforce under its own fee schedules, rules and appeal processes — neither commercial insurance nor Medicaid, and consequential enough in this state to treat as its own payer discipline.
Where we work in West Virginia
We support practices across the state remotely — same-day claim submission and a dedicated team regardless of your zip code. The markets we serve most:
Credentialing & enrollment in West Virginia
Physician licensing in West Virginia runs through the West Virginia Board of Medicine, and payer enrollment is its own workstream on top of it — state Medicaid enrollment, CAQH upkeep, and individual plan contracting each on their own timeline. Our credentialing service manages the full stack for West Virginia providers, and our credentialing calculator estimates realistic timelines by payer.
West Virginia billing FAQs
What is the timely filing limit for West Virginia Medicaid?
Commonly published at 365 days from the date of service, with Mountain Health Trust MCOs — Aetna, The Health Plan, UniCare — setting working limits in their manuals.
What is PEIA and how does it bill?
The Public Employees Insurance Agency covers West Virginia's public workforce under its own fee schedules and rules — a payer class of its own that we bill on its own terms, not as generic commercial coverage.
Do you handle behavioral health and SUD billing in West Virginia?
Extensively — treatment-infrastructure billing carries outsized share here, and the MCOs' BH/SUD rules, auth requirements and rate structures are core daily work.
Do you work with The Health Plan?
Yes — the Wheeling-grown carrier spans Medicaid and commercial lines, and its provider-affiliated roots give it a distinct rulebook we work regularly.
Medical billing services in other states
Ready to stop losing revenue in West Virginia?
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