Delaware practices, Novitas rules first

Cardiology billing services in Delaware

Sources checked: 2026-09-30. Sources and review scope.

Cardiology billing services in Delaware start with Novitas, your Medicare contractor for jurisdiction JL. Its published coverage policies are one part of Medicare claim requirements. Policies can overlap across contractors, so payment under one contractor doesn't guarantee payment under another. We bill cardiology only, remotely from Texas, at 3% of collections.

Talk to our team Explore pricing

3% of collectionsNo setup feeNo contract

Cardiology billing services in Delaware: the Wilmington riverfront skyline — Delaware Medicare claims go to Novitas

01Medicare

How Novitas pays cardiology in Delaware

Novitas processes Medicare claims for jurisdiction JL: Delaware, New Jersey, Pennsylvania, Maryland and Washington, DC. It writes its own local coverage policies for echo, nuclear imaging and cardiac monitoring. A study that pays under one contractor can be denied under another.

We check the applicable policy before filing. If documentation appears incomplete, we flag it for the practice to review before submission. Only the treating clinician can determine or change clinical documentation.

Held before submission

Claim 30811Holter monitor · 93224

Documentation receivedClaim 30811

Record review

Documentation flagged for practice review

Our checkHeld

Practice reviewClaim 30811

Ready to submit

Practice confirms documentation

Claim statusReady

Indication documented before sending

02Payers

The Delaware payers we bill

Your schedule carries Highmark Blue Cross Blue Shield Delaware, Aetna, Cigna and UnitedHealthcare. Delaware Medicaid runs through the Diamond State Health Plan, a managed care program. Its plans are Highmark Health Options, AmeriHealth Caritas Delaware and Delaware First Health.

Many patients carry a Blue plan from Pennsylvania, Maryland or New Jersey. Those claims go to Highmark Delaware through BlueCard, then to the home plan. We trace each one until it pays, so it doesn't sit between two Blue plans.

How we post payments

Routed through BlueCard

Claim 30846Maryland Blue plan · echo 93306

SentTo Highmark Delaware as the local plan
RoutedTo the patient's home Blue plan
PaidTracked until the payment posts

Out-of-state Blue plans traced

03Your city

Cardiology practices we serve in Wilmington, Newark, Dover, Lewes

We're built for independent practices of 1 to 10 cardiologists. Echo, vascular, nuclear, monitors or a device clinic run in the office. Near Wilmington and Newark, patients cross in from three states. Down in Sussex County, around Lewes, Medicare and Medicare Advantage fill much of the day.

Medicare contractor routing depends on the service location, not the patient's home state. We confirm the applicable contractor for the practice location and check CMS ZIP-to-locality and fee-schedule information by service date.

Service location checked

Claim 30872Device check · 93280

Service ZIP confirmedChecked
Patient's home state noted for coordinationChecked
Novitas jurisdiction checkedChecked
Current locality and fee schedule verifiedChecked
Claim statusPaid

Contractor and locality by service location

04Switching

Switching from a local biller

Leaving a local biller whose BlueCard claims kept stalling? The switch runs on a 60-day plan. Claims keep moving while we work the old A/R and trace open BlueCard claims.

Your dedicated biller learns your contracts and your doctors, and stays with you. You talk to someone who knows cardiology. Mon to Fri, 9 to 5 Central.

Your first 60 days with us

Claims keep moving

Your switchFirst 60 days

Day 1New claims sent dailyStarted
Weeks 1 to 8Old A/R worked in parallelOngoing
Weeks 1 to 8Open BlueCard claims tracedOngoing
Day 60Your biller fully on the accountDone
Your claimsMoving

Old A/R worked alongside new claims

05Questions

FAQ

We see patients from three states. Can you bill their plans?

Yes. We bill in all 50 states, so Pennsylvania and Maryland plans on a Delaware schedule are routine.

Do we need to change our EHR?

No. We work in the system you already have.

What does it cost?

3% of collections. No setup fee, no contract, no per-claim charges.

Sources and review context

Checked on September 30, 2026. This administrative source check is not a clinical or credentialed coding review, legal opinion, payer-contract audit, or guarantee of coverage or payment.

Medicare contractor: CMS's JL jurisdiction page identifies Delaware and the other JL states. CMS's MAC directory links state provider websites.
Fee schedule and locality: CMS's CY 2026 Physician Fee Schedule locality data and CMS fee-schedule downloads and ZIP-to-locality guidance support checking a service ZIP and date. No statewide Medicare rate is promised here.
Delaware Medicaid: The state DMMA site describes the Medicaid agency and provider portal provides provider participation and claims resources. The body names the Diamond State Health Plan as the managed-care program.
Commercial payer: BCBSA's state company directory lists Highmark Blue Cross Blue Shield Delaware. It does not establish market share or a specific contract's terms; verify the member's product and provider agreement.

06Get in touch

Send us your last 90 days of claims

We review them by study and by payer, free, with no strings.

Talk to our team Explore pricing

3% of collectionsNo setup feeNo contract

Free, no strings

Your 90-day Delaware reviewLast 90 days

Every claim, by studyIncluded
Out-of-state Blue plans tracedIncluded
Checked against Novitas policyIncluded