Medical Billing Company in West Virginia | Mountain Health Trust

Mountain Health Trust covers approximately 87 percent of West Virginia's Medicaid membership through four Managed Care Organizations: Aetna Better Health of West Virginia, The Health Plan of West Virginia, Highmark Health Options West Virginia, and Wellpoint (formerly UniCare). Highmark Health Options is the newest entrant, having begun receiving Medicaid membership on August 1, 2024. Each MCO's contracted service area covers all 55 of West Virginia's counties, and the four plans collectively contract with providers across more than 100 specialties. A separate program, Mountain Health Promise, provides specialized managed care for children and youth in foster, kinship, and adoptive care, administered solely by Aetna Better Health of West Virginia rather than split across all four MCOs. Several services are carved out of Mountain Health Trust and billed on a fee-for-service basis directly to the state rather than through an MCO, including point-of-sale pharmacy, long-term care, home and community-based waiver services, and non-emergency medical transportation. A bill introduced in the West Virginia Legislature in February 2026 (HB 5266) would require all Mountain Health Trust MCOs to contract with any willing, qualified provider at comparable reimbursement terms, which could affect network participation rules if enacted. Mediknocx's billing team distinguishes which services route through an MCO's capitated contract and which fall into the state's fee-for-service carve-out before submitting West Virginia Medicaid claims.