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Revenue Increase
Collection Ratio
Billing Specialties
Clean Claims
Streamline your revenue cycle with accurate coding, faster claim submissions, and reduced denials tailored for Indiana providers.
Reduction in A/R
Indiana providers are working in one of the most administratively challenging Medicaid settings in the nation. The Indiana Health Coverage Programs (IHCP) covers a variety of models of delivery and managed care organizations, each with different prior authorization regulations, claim forms, and portal submissions processes. The complexity of operating as a company on such complexity strains your staff, slows collections, and risks revenues each and every billing cycle.
MedCare MSO assumes full ownership of your revenue cycle - real time eligibility verification and capture of charges through denial management, appeal and payment reconciliation, so nothing falls through the cracks and each dollar you earn is collected promptly.
MedCare provide assistance with:
The holes in the revenue collection process do not fix themselves, and with the intricate payer mix in the state of Indiana, the differences between the amount you are billing and the amount you are collecting may silently continue to grow month after month. The foundation of our medical billing services Indiana providers have to count on is to ensure that your practice is paid correctly, fully, and in a timely manner behind every service you provide. We will bridge those gaps in each phase - and the outcomes will speak volumes.
Indiana's healthcare billing environment is among the most demanding in the nation. From IHCP program complexity and MCE variability to EDI rejections and audit exposure, the number of ways revenue can leak from your practice is significant. MedCare MSO addresses every one of these challenges directly protecting your revenue at every stage of the cycle.
Indiana Medicaid (IHCP) consists of various programs and delivery models – such as Hoosier Care Connect, Hoosier Healthwise, and PathWays to Aging – each with different billing regulations, fee schedules, and requirements to submit claims. The Indiana Family and Social Services Administration (FSSA) provides updates on policies that need to be monitored and adjusted to the workflow. MedCare MSO monitors all updates to IHCP programs and makes sure that your billing processes are up to date and comply with the latest requirements.
Indiana Medicaid channels members through a series of Managed Care Entities, each operating under its own prior authorization regulations, claim format, payer specific edits, and portal submission workflows. Submission to the wrong MCE or an incorrect format of claim to a particular plan results in automatic denials. Our team ensures that MCE-specific billing protocols are up-to-date and ensure that the MCE-specific billing protocols are enforced in every check-in of a patient.
Indiana Medicaid patients often undergo a shift in eligibility, such as a change in plans or the termination of coverage or retroactive adjustments in eligibility which, when missed, leads to claim rejections and delayed reimbursements. MedCare MSO is also real-time eligibility checks prior to each encounter to minimize chances of filing claims against inactive or incorrect coverage.
The strict prior authorization practices of Indiana payers and the absence or inaccuracy of prior authorization information is one of the primary reasons behind hard denials and backlog of appeals. MedCare MSO handles all prior authorization lifecycle – not from submission and follow-up through retro authorization requests but from submission and follow-up through retro authorization requests.
Keep using the software you already know. We connect to all major platforms seamlessly. No disruption to your workflow. Integration happens smoothly and quickly.
MedCare MSO stands out as a top medical billing partner built to transform how your practice manages revenue and operations. With AI-powered, cloud based medical billing systems, it connects your scheduling, billing, and reporting into one simple platform, so nothing falls through the cracks. Instead of chasing payments, you get cleaner claims, faster reimbursements, and clear financial visibility.
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The Medicaid program in Indiana the Indiana Health Coverage Programs (IHCP) program works across multiple delivery models and routes members through multiple Managed Care Entities each with different prior authorization rules, claim format and portal submission requirements. Before they submit claims, providers should discover the correct IHCP program and MCE of each patient, as incorrect route claims or improper formats result in automatic rejections.
Outsourcing Indiana medical billing services can enable practices to achieve cost savings by eliminating overhead costs that are tied to in-house billing staff, reduce billing errors due to staff turnover and training lapses, and access experts who can monitor changes in IHCP policies, MCE rule changes, and payer compliance requirements in real time.
Yes. MedCare MSO has wide experience in handling IHCP fee-for-service claims and MCE-directed claims on behalf of enrolled Indiana Medicaid members. In real-time eligibility verification, our team verifies that each patient is enrolled in the IHCP program and assigned to the specific MCE, routes the claims accordingly, and adheres to the particular authorization, documentation and claim form requirements of that MCE.
Indiana Medicaid fee-for-service claims are typically due within 12 months of the date of service. But individual MCEs might have stricter filing timelines, some plans have a filing timeline of 90 to 180 days. Appeal filings, corrected claims and secondary claims all have their own deadlines as well. MedCare MSO is an automated tracking system that tracks the submission date, denial date, and available resubmission window of every claim using automated tracking systems so that no revenue opportunity is lost to a missed deadline.
Ready to maximize your revenue while reducing administrative work? Let’s team up! Our medical billing expert will reach out within 12 hours.
