Medical Billing Services in Indiana
Indiana Medicaid is not one program, it is four, and each one runs through a different set of managed care organizations. A child, an expansion adult, a disabled adult, and an older adult needing long term care can sit in the same waiting room and belong to four different billing paths. Sorting the patient into the right program and the right plan before the claim goes out is the core discipline of Indiana billing.
MedPlus RCM provides medical billing, coding, credentialing, and denial management for Indiana practices of every specialty, built around the state’s actual payers and programs.
Indiana’s payer landscape
Indiana Medicaid runs under the Indiana Health Coverage Programs (IHCP), with most members served through managed care. The four managed care programs are the Healthy Indiana Plan (HIP) for adults, Hoosier Healthwise for children and pregnant women, Hoosier Care Connect for adults who are blind or disabled, and Indiana PathWays for Aging for older adults who need long term care. The managed care organizations serving these programs are Anthem, CareSource, Managed Health Services (MHS), UnitedHealthcare, and Humana, though not every organization serves every program. Humana, for example, serves PathWays only, while Anthem serves all four. MDwise ended its participation in HIP and Hoosier Healthwise on January 1, 2026, and the state is reprocuring all four programs, so the plan roster will change again when the new contracts take effect. Enrollment and program assignment have to be verified for each date of service, not assumed from a prior visit.
Commercial coverage is led by Anthem Blue Cross Blue Shield, alongside UnitedHealthcare, CareSource, and Indiana University Health Plans. Medicare Advantage prior authorization touches a significant share of schedules in the Indianapolis and Fort Wayne metros.
What MedPlus RCM handles for Indiana practices
- End-to-end medical billing. Charge entry, claim scrubbing, submission, payment posting, and patient billing. That is the full cycle.
- Medical coding. Certified coders assign current ICD-10, CPT, and HCPCS codes matched to your documentation and specialty.
- Provider credentialing and enrollment. End-to-end enrollment with IHCP managed care organizations, commercial payers, and Medicare, plus re-credentialing maintenance.
- Denial management and recovery. Every denial investigated to root cause, corrected, and appealed with documentation.
- A/R recovery. Aged and outstanding balances audited and pursued, including balances already written off where the appeal window is still open.
- Financial reporting. Clean claim rates, collections, denial patterns, and A/R aging visible by payer and provider.
We serve practices statewide, Indianapolis, Fort Wayne, Evansville, South Bend, Bloomington, and Lafayette, across specialties including primary care, mental and behavioral health, cardiology, orthopedics, dermatology, and physical therapy.
Results Indiana practices can check
MedPlus RCM maintains a 99% clean claim rate and keeps client accounts receivable under 30 days. Pricing is a performance-based percentage of successfully collected revenue: if you don’t get paid, we don’t get paid. We are 100% HIPAA compliant, and onboarding takes 2 to 4 weeks depending on practice size, with no disruption to your daily cash flow.
Frequently asked questions
Why is Indiana Medicaid billing complicated?
Four programs, each with its own managed care roster, and the roster itself is changing. MDwise left HIP and Hoosier Healthwise at the start of 2026, and a full reprocurement is underway. A claim billed to the right program but the wrong plan, or to a plan the patient no longer belongs to, will deny.
Do you work with Indiana Medicaid managed care plans?
Yes. We bill Anthem, CareSource, Managed Health Services, UnitedHealthcare, and Humana across the IHCP programs they serve, as well as fee-for-service Indiana Medicaid, commercial payers, and Medicare.
How long does it take to switch our billing to MedPlus RCM?
Onboarding takes between 2 and 4 weeks depending on practice size, including data migration and payer clearinghouse setup.
What does MedPlus RCM charge?
A performance-based percentage of successfully collected revenue. If you don’t get paid, we don’t get paid.
Get a free financial audit
Find out where your Indiana practice is losing revenue. Request a free financial audit and our specialists will review your claims, denials, and A/R.
