Home / Locations / Massachusetts
Medical billing and credentialing services in Massachusetts
Massachusetts practices bill MassHealth, Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim and a deep field of regional plans. Core MB supports credentialing and billing for Bay State providers from Brooklyn, with a clear view of how those payers differ.
Practices we support in Massachusetts
- Boston
- Worcester
- Springfield
- Cambridge
- Lowell
- Statewide
Provider credentialing and payer enrollment in Massachusetts
Physicians in Massachusetts hold a license from the Board of Registration in Medicine before any payer will move forward. From there, enrollment covers MassHealth, which operates under the Executive Office of Health and Human Services, plus Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim, Tufts Health Plan and Fallon Health. Massachusetts has many accountable care and managed care arrangements, so confirming which network and plan product a provider is actually joining is a state-specific step.
Massachusetts payer snapshot
The programs and plans most Massachusetts practices enroll with first.
- Medicaid
- MassHealthExecutive Office of Health and Human Services
- Blue plans
- Blue Cross Blue Shield of Massachusetts
- Other payers
- Harvard Pilgrim Health Care, Tufts Health Plan, Fallon Health and WellSense Health Plan
- Medicare
- National Government ServicesPart A and B claims administrator for Massachusetts
- Licensing
- Massachusetts Board of Registration in Medicine
Medical billing and revenue cycle management in Massachusetts
Billing in Massachusetts means tracking MassHealth fee-for-service alongside managed care and accountable care organization members, with Medicare and commercial plans from BCBSMA, Harvard Pilgrim and Tufts layered on top. Common friction includes eligibility that changes mid-month, referral or primary care assignment mismatches, and claims filed to the wrong plan. Regular denial review and prompt resubmission matter more here than in single-plan markets.
- Insurance verification and eligibility checks
- Charge entry and specialty-specific coding review
- Claim scrubbing and electronic submission
- Payer follow-up on every open claim
- Denial management and appeals
- Payment posting and reconciliation
- Accounts receivable recovery
- Patient statements and balance support
- Monthly reporting you can read in five minutes
Websites, marketing and virtual assistants for Massachusetts practices
Boston and Cambridge patients compare practices carefully, often through map results and reviews, while Worcester and Springfield searches lean local. We build clear practice websites, manage local search and Google Business Profiles, and provide HIPAA-compliant medical virtual assistants for calls, scheduling and verification.
- Website design and development
A fast, accessible practice website with services, providers, locations and insurance accepted, built for every business, not only healthcare. Web development →
- Healthcare digital marketing
Local search, Google Business Profile and campaigns aimed at the patients and referral sources near your Massachusetts locations. Digital marketing →
- HIPAA-compliant medical virtual assistants
Trained remote staff for scheduling, eligibility, intake and follow-up, working inside your systems. Medical virtual assistants →
How Massachusetts practices start with Core MB
Core MB is based in Brooklyn, New York and works with practices in Massachusetts remotely. Nothing about the service depends on distance: payer portals, clearinghouses and your practice management system are the same wherever the office sits.
Tell us about the practice
Specialty, providers, locations and the payers you bill or want to join. One conversation is usually enough.
Receive a written proposal
Scope, timeline and responsibilities in plain language, whether you need one service or all five.
Onboard without disruption
Transitions run alongside your current setup, and credentialing progress is visible in your client portal from day one.
Massachusetts billing and credentialing questions
How does a provider enroll with MassHealth?
Providers submit an application through MassHealth's provider enrollment process, administered under the Executive Office of Health and Human Services, and must hold an active Massachusetts license. Many members are served through managed care or accountable care organizations, so network participation is a further step.
Which payers matter first for a new Massachusetts practice?
Blue Cross Blue Shield of Massachusetts and Medicare are usually first, followed by Harvard Pilgrim, Tufts Health Plan and MassHealth. Regional plans such as Fallon Health can matter heavily in central and western parts of the state, depending on your patient base.
Is MassHealth enrollment enough to see managed care members?
Not by itself. MassHealth enrollment makes you an eligible provider, but plans and accountable care organizations that serve MassHealth members credential and contract separately. We confirm network status for each plan before scheduling those patients, so claims are not denied for being out of network.
Do we need to be near Brooklyn to work with Core MB?
No. Everything runs remotely: enrollment applications, payer follow-up, claims and reporting. Practices in Massachusetts get the same team, the same client portal and the same monthly reporting as a practice around the corner from our office.
Ready to get paid faster in Massachusetts?
Tell us about your practice and the payers you bill, and we will send a written quote.