Medical Billing Built for West Virginia Healthcare Providers
West Virginia expanded Medicaid effective January 2014, one of the earliest states to do so. Medicaid managed care is delivered through Mountain Health Trust, which covers roughly 87% of the state's Medicaid population through four contracted MCOs: Aetna Better Health of West Virginia, Highmark Health Options West Virginia, The Health Plan of West Virginia, and Wellpoint West Virginia. A related carve-out program, Mountain Health Promise, is a specialized managed care plan — run solely by Aetna Better Health — for children and youth in foster care, kinship care, and adoptive care, so those claims route differently than standard Mountain Health Trust members. On the commercial side, Highmark West Virginia, the state's Blue Cross Blue Shield licensee, is the dominant payer, so its documentation and prior-authorization rules affect more claims here than in most states.
Whether you're in Charleston, Huntington, Parkersburg or anywhere else in West Virginia — ZenoMedix RCM provides the same certified billing expertise with deep knowledge of local payer rules and West Virginia Medicaid requirements.
Major Payers We Work With in West Virginia
West Virginia Medicaid
Mountain Health Trust — West Virginia's Medicaid managed care program, covering about 87% of the state's Medicaid population through four MCOs: Aetna Better Health of West Virginia, Highmark Health Options West Virginia, The Health Plan of West Virginia, and Wellpoint West Virginia. Foster care and kinship youth route through the separate Mountain Health Promise plan via Aetna Better Health. West Virginia expanded Medicaid in January 2014.
HIPAA Compliance
Full HIPAA compliance for all WV providers. We stay current with all West Virginia billing regulations. View HIPAA Statement →
Every City in West Virginia — We're Your Billing Team
Remote billing means you get the same expert service whether you're in a major metro or a smaller community across West Virginia.
75+ Specialties Served Across West Virginia
Each specialty has a dedicated billing team trained on its CPT codes, modifiers, and payer-specific requirements in West Virginia.
Everything Your Practice Needs — Nothing You Don't
West Virginia Billing FAQ
Often, yes — a common cause is submitting to the wrong Mountain Health Trust MCO. West Virginia Medicaid managed care runs through four contracted plans — Aetna Better Health of West Virginia, Highmark Health Options West Virginia, The Health Plan of West Virginia, and Wellpoint West Virginia — and we confirm the correct one before submitting rather than guessing.
No. Foster care, kinship care, and adoptive care youth are covered under Mountain Health Promise, a separate specialized managed care plan run solely by Aetna Better Health, not standard Mountain Health Trust. We route those claims to the correct program.
Yes. Highmark West Virginia, the state's Blue Cross Blue Shield licensee, is the dominant commercial payer here, and our coding team bills it regularly alongside UnitedHealthcare, Aetna, Cigna, and The Health Plan, tracking each payer's documentation requirements.
Most West Virginia practices are fully onboarded and submitting live claims within 48 hours of signing. We're month-to-month — no long-term contract — and we work your existing claims backlog into the transition so nothing falls through.
We serve West Virginia practices statewide, from Charleston, Huntington, Parkersburg, Morgantown, and everywhere in between — not just the biggest metro area.