Charge entry and claim submission run daily for every Indiana client. Claims are scrubbed against IHCP and managed care edits first, so fewer come back for a wrong rendering NPI or a missing taxonomy code.
Certified coders assign ICD-10, CPT, and HCPCS codes straight from the documentation. Plenty of Indiana practices undercode E/M visits out of caution, and that caution adds up to real money by year-end.
We verify coverage through the IHCP Provider Healthcare Portal and each plan's portal before every visit. Hoosiers move between HIP, Hoosier Healthwise, and Hoosier Care Connect more often than most front desks realize.
Anthem, CareSource, and MHS each run their own authorization rules, and the PathWays plans add more on top. Our team submits requests and follows up daily so procedures don't get pushed back.
Every denial is categorized by root cause and payer. After a plan exit like MDwise, we also catch claims still being sent to the old plan, which happens far more than you'd think.
Aging claims get worked on a weekly schedule. IHCP gives providers 180 days from the date of service to file, and a claim that bounces twice can eat most of that window.
Clear statements and a support line that answers keep Indiana patients paying on time. Patients with questions about HIP cost-sharing get real answers, not hold music.
We handle IHCP enrollment and revalidation, MCE credentialing, Medicare enrollment through PECOS, and commercial applications. Another procurement is coming, so clean credentialing records matter more than usual.
One team runs the whole cycle, from scheduling to the last payment posted. You stop playing referee between the front desk and the billing office.
Every remittance is posted and checked against your contracted rate. Underpayments from Indiana payers get flagged and appealed, not written off.
Patients cross into Indiana from Illinois, Ohio, Kentucky, and Michigan for care. When a claim falls out of network, we build a fair-market case and negotiate directly with the payer. Federal independent dispute resolution is covered too, when the No Surprises Act applies.
Monthly reports show collections and denial rates by provider and by payer. You'll usually know which plan is slowest to pay by the end of the first report.
All billing runs on secure, HIPAA-compliant systems with role-based access. A signed business associate agreement comes on day one, before any patient data changes hands.
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Happy Clients
Most Indiana practices pay a percentage of monthly collections, so our fee rises only when your revenue does. Your rate depends on specialty, volume, and the services you pick. We'll quote it after a free audit.
Yes. We bill all four Indiana Medicaid managed care programs plus traditional fee-for-service IHCP. IHCP enrollment and revalidation are part of the service too.
We re-verify affected patients and update payer setups before the switch. Claims already sent to the exiting plan get followed to payment before its runout window closes.
Yes. We confirm your practice's enrollment with the patient's home-state Medicaid program and handle out-of-state enrollment where it's needed. Claims then go through the right channel the first time.
We work inside most major EHR and practice management systems already used by Nevada practices, so your team does not need to learn new software.
Usually a few weeks. We set up payer connections, review open AR, and run in parallel with your current process so claim submission never pauses.
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