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Why we run this
Luxen is a medical billing company. We do this work commercially for practices above $1M in annual revenue. The clinic is that same work, given free to the practices below that line, which are the ones least likely to ever hire a billing company.
We work with practices across the country. We have been running free Medical Billing Clinics for some time now and this is the first time we are bringing one to Delaware. Providers have found tremendous value in it and we hope you do too.
What the clinic covers
Ninety minutes, worked from your own claims rather than from slides.
- The filing window most Delaware practices get wrong. Delaware Medicaid allows twelve months from the date of service. The Medicaid managed care plans do not. Delaware First Health, for example, requires first-time claims within 120 calendar days. A practice that treats every Medicaid patient as a twelve-month claim loses money on the managed care ones and often does not notice for a year.
- Which denials are worth appealing. How to rank open denials by dollar value and remaining deadline instead of working them in the order they arrived.
- What to do when another insurer is primary. Delaware Medicaid gives you six months from the date you receive the primary payer's decision, even when that lands beyond the twelve month window. Most practices never use it.
- Credentialing a new provider without losing months of insured visits to paperwork.
- The three or four root causes behind most of your denials, and how to fix them upstream so the same claims stop coming back.
What you leave with
- Appeal letter templates for the most common denial reasons.
- A filing deadline calendar covering Delaware Medicaid and each of the three Diamond State Health Plan managed care organizations, which do not share the same windows.
- A written list of which of your own claims we believe are still recoverable, and what to file for each.
All of it is yours to use whether or not you ever speak to us again. If it were only useful with us doing the work, it would not be a giveaway.
Who can attend
Delaware medical and dental practices with under $750,000 in annual revenue. In practice that is one and two provider offices with no dedicated biller, where appeals compete with everything else on the office manager's desk.
Bring whoever actually touches billing. That is often the practice manager rather than the provider.
There are 20 places and registration closes on Friday, Sept 23. No sales call is required to attend, and we will not schedule one unless you ask.
Why Delaware practices lose money in a particular way
Delaware is small enough that most practices deal with a short list of payers. Highmark Blue Cross Blue Shield Delaware dominates the commercial side. On the public side, Medicaid runs through the Delaware Medical Assistance Program, and members are enrolled in Diamond State Health Plan, which is delivered by managed care organizations rather than by the state directly: Highmark Health Options, AmeriHealth Caritas Delaware and Delaware First Health.
That distinction is where the money goes missing.
Twelve months, or 120 days. DMAP requires claims within twelve months of the date of service, which is a federal requirement. Where another insurer or Medicare is primary, you get six months from the date you receive notice of their decision, even if that lands more than twelve months after the service. The managed care plans set their own windows and they are far shorter. Delaware First Health requires first-time claims within 120 calendar days of the date of service. Same patient population, same state, wildly different deadlines, and nothing on the claim tells you which one applies.
Adjustments. A paid DMAP claim can be adjusted within two years of the date of service. Beyond that, only voids and positive adjustments are allowed, up to five years from the date of payment.
Delaware has about a million residents across three counties, so a practice's payer mix is concentrated and a single plan's policy change moves your denial rate quickly. There is no diversified book of business to absorb it.
For reporters
In one sentence: a medical billing company is working unpaid insurance claims for free for 20 small Delaware medical and dental practices, and the practices keep everything recovered.
Why it matters to readers: when a small practice cannot get an insurer to pay, that balance often lands on the patient's bill. Patients end up owing money their insurance should have covered.
The facts: free, Wednesday October 01 2026, 20 places, open to Delaware medical and dental practices under $750,000 in annual revenue, registration closes Friday Sept 23.
Contact: Shivam Pujara, 413 445 1050. Happy to explain how a denied claim turns into a patient bill, connect you with a participating practice, or share what we find across all twenty practices afterwards. Photo and logo available on request.
Questions
Is it really free? Yes. No fee, no card, and no sales call is required to attend. This is our way to give back to the community and raise awareness on the correct practices for small clinics.
What do I need to bring? Your unpaid and denied claims, or an AR ageing report if you can pull one. The more you bring, the more useful it is.
What if we are already with a billing company? You can still come. Some of what we find will be things to take back to them.
Is my practice too small? Almost certainly not. The clinic exists specifically for practices too small to justify a billing company.
What happens to our data? We sign a business associate agreement before seeing anything containing protected health information, and healthcare work runs on HIPAA-compliant tooling.
Register, or ask first
Twenty places, and registration closes on Friday, Sept 23. If you would rather ask something before signing up, call Shivam Pujara on 413 445 1050.
We request that if you are a clinic doing much more than a million dollars in revenue you do not take up a spot for this workshop since it is exclusively focused on clinics who are smaller in nature.
