Nevada Med Billing handles medical billing, coding, credentialing, and revenue cycle management for healthcare providers across the state, from busy multi-specialty groups in Clark County to small clinics out in Nye and Elko counties. We work with Nevada Medicaid's managed care plans, the Culinary Health Fund, and Nevada's surprise billing law every single day, so nothing about your state's rules catches us off guard.
One live dashboard for collections, clean claim rate, and A/R, so you're not left chasing your billing company for a status update every time you want an answer.
Results Nevada practices see when the revenue cycle is run end to end.
Years in business
Claims processed
Average days in A/R
Clean claim rate
Client retention rate
Dollars collected for Nevada clients
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Our process runs against Nevada's actual regulations from the start. Before a claim ever goes out, we check it against current Nevada Medicaid MCO rules, Culinary Health Fund requirements where they apply, and the state's prompt pay and surprise billing statutes. That check happens before submission, not after a denial lands in your inbox weeks later.
Here's what Nevada billing looks like day to day.
From the eligibility check at the front desk to the last dollar recovered in A/R, everything runs through one accountable team based right here in Nevada.
Coding that actually understands what your specialty bills for.
We also bill for podiatry, chiropractic, physical therapy, wound care, anesthesia, DME, ABA therapy, neurology, endocrinology, urology, ophthalmology, and more than thirty other specialties.
See all specialtiesNo two Nevada payers work exactly alike, so we don't treat them like they do.
Anthem BCBS Healthcare Solutions, Health Plan of Nevada, Molina Healthcare of Nevada, SilverSummit Healthplan, CareSource. Administered by the Division of Nevada Medicaid, part of the Nevada Health Authority.
Culinary Workers Union health plan, covering more than 130,000 hospitality and gaming industry members in the Las Vegas area.
UnitedHealthcare, Anthem, Prominence Health Plan, UMR. The commercial plans we bill against most often outside of Medicaid managed care.
Nevada workers' comp carriers, third party liability, and attorney lien claims, handled under Nevada's workers' compensation laws.
We deal with these payers often enough to know which ones want a modifier attestation before they'll pay, which ones give you ninety days to file a workers' comp claim, and which recent Medicaid changes, like the 2026 expansion of managed care into rural counties, are actually going to affect your claims.
What counts as a correct claim in Nevada isn't always what counts as correct somewhere else. We stay on top of:
Billing for a large group in Clark County looks nothing like billing for a small clinic out in Nye County, so we build our workflows around both. These rural accounts run on fee for service Medicaid, FQHC and rural health clinic rules, and often a much smaller administrative staff.
End-to-end, HIPAA-secure billing that lifts collections for clinics across every Nevada county.
Explore all locationsYour data syncs automatically, which means fewer manual errors and a faster path to a clean claim.
We go through your last 90 days of claims against Nevada payer and Medicaid MCO rules to find out exactly where revenue is slipping through.
EHR access, payer setup, and staff handoff, usually done in two to three weeks.
Certified coders take over, and daily claim submission begins.
Every claim gets worked until it's paid, denied and appealed, or otherwise resolved.
Monthly reporting ties every stage of the cycle back to what actually landed in your account.
You shouldn't have to call your billing company to find out how you're doing. We report on what matters — collections, denials, and A/R trends — every month, automatically.
A dedicated account manager, not a rotating cast of support agents who make you start from zero on every call.
AAPC and AHIMA certified coders review every claim before it goes out, not after it bounces back.
HIPAA compliant infrastructure with a signed Business Associate Agreement on every engagement, in writing, not just promised.
Monthly reporting that connects directly to what actually landed in your account, so the numbers always make sense.
We earn your business month over month, not through a contract you can't get out of.
We already understand your Medicaid MCO, your Culinary Health Fund requirements, and your AB 469 obligations, instead of a national vendor learning your state on your dime.
Real Nevada providers on what changed after they switched.
Our days in A/R dropped from 58 to 22 in the first two quarters. More importantly, we finally have monthly reports that tell us why, not just what.
Prior authorization used to delay our infusion schedule by weeks. Nevada Med Billing's team tracks every renewal before we even ask.
Our days in A/R dropped from 58 to 22 in the first two quarters. More importantly, we finally have monthly reports that tell us why, not just what.
Prior authorization used to delay our infusion schedule by weeks. Nevada Med Billing's team tracks every renewal before we even ask.
We switched EHRs mid year and were terrified of a billing gap. The transition was seamless. Claims never stopped going out.
Our front desk finally isn't drowning in insurance calls. Eligibility issues get caught before the patient even walks in.
We switched EHRs mid year and were terrified of a billing gap. The transition was seamless. Claims never stopped going out.
Our front desk finally isn't drowning in insurance calls. Eligibility issues get caught before the patient even walks in.
Denial management alone paid for the entire service. We recovered claims we'd already written off from our previous biller.
Cardiac imaging prior auths used to sit for a week. Now they're submitted and tracked the same day the procedure is scheduled.
Denial management alone paid for the entire service. We recovered claims we'd already written off from our previous biller.
Cardiac imaging prior auths used to sit for a week. Now they're submitted and tracked the same day the procedure is scheduled.
Can't find what you need? Our Nevada team answers every question before you commit.
A full-service billing partner should handle a lot more than just sending claims out the door. That includes eligibility verification before the visit, coding by certified professionals, claim submission, payment posting, denial management, A/R follow up on anything that hasn't paid, patient statements, and credentialing when a provider joins or changes payers. In Nevada specifically, it also needs to cover Medicaid managed care rules, Culinary Health Fund requirements if your patient population includes hospitality workers, and compliance with the state's surprise billing and prompt pay laws. If a billing company only touches claim submission and nothing else, you're still doing half the work yourself.
Yes, it's AB 469, and it's codified at NRS 439B.700 through 439B.760. The law sets up an arbitration process for emergency claims that fall outside a patient's standard payer network, so patients aren't stuck with a massive out of network bill after an emergency they didn't choose. For practices, the important part is the process itself. There's a specific sequence for submitting these claims and pursuing arbitration if the payer disputes the amount, and missing a step in that sequence is one of the most common reasons an otherwise valid emergency claim ends up sitting unpaid for months.
Nevada's prompt pay law, NRS 683A.0594, requires insurers to pay a clean electronic claim within 30 days of receipt. The word clean is doing a lot of work in that sentence though. If a claim has an error, a missing modifier, or incomplete documentation, that 30-day clock doesn't really protect you, because the payer can simply deny or pend it and the timeline resets once you resubmit. That's exactly why getting a claim right the first time matters so much more in Nevada than in states without this kind of statute.
Yes, and this is genuinely one of the more complicated parts of billing in this state. Nevada Medicaid runs through five separate managed care organizations, Anthem BCBS Healthcare Solutions, Health Plan of Nevada, Molina Healthcare of Nevada, SilverSummit Healthplan, and CareSource, and each one has its own prior authorization requirements and its own preferences around modifiers. We stay current on all five, and we check every submission against the current Nevada Medicaid Services Manual and Known Issues list before it goes out, not after it bounces back.
Yes, and if your practice sees patients from Las Vegas's hospitality and gaming industry, this matters more than you might think. The Culinary Health Fund covers more than 130,000 members in the Las Vegas area, and its billing rules differ from standard commercial insurance in ways that trip up billers who don't work with the plan regularly. We handle Culinary Health Fund claims often enough to know its specific documentation and authorization requirements without having to look them up every time.
No, and honestly this is one of the bigger gaps we see in this industry. A lot of billing companies focus entirely on Clark and Washoe County and treat rural Nevada as an afterthought. We work with practices across the state, including clinics in Nye, Elko, Churchill, Humboldt, Lyon, and Douglas counties, where fee for service Medicaid, FQHC billing, and sliding fee schedules are the norm rather than the exception. It's a genuinely different kind of billing work, and we built our processes to handle both sides of that divide well.
Most billing companies, us included, charge a percentage of collections rather than a flat monthly fee, and that percentage typically falls somewhere between 4% and 9% depending on your specialty, your claim volume, and how much of the revenue cycle you're outsourcing. A single provider primary care practice usually lands toward the lower end of that range, while high complexity specialties like oncology or cardiology tend to sit higher because of the added coding and prior authorization work involved. We give you an actual number during the free audit, based on your real claim history, rather than a generic industry range.
Request a free, no obligation billing audit. We'll go through your last 90 days of claims and show you exactly where revenue is getting delayed or lost.
Prefer to talk it through? Call (702) 555-0184.
