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Revenue Cycle Management Services
in Indiana
Qualigenix runs the revenue cycle for independent Indiana practices, from the eligibility check to the final patient balance, and charges a percentage of collections. Every step is HIPAA compliant.
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How Qualigenix Serves Indiana Practices
Qualigenix provides revenue cycle management services to independent practices across Indiana and works every payer your patients carry. In a typical Indiana office, a large share of visits involve IHCP members, whose plans cover more than 1.4 million Hoosiers across HIP, Hoosier Healthwise, Hoosier Care Connect and PathWays. The rest are Medicare, Medicare Advantage and commercial patients. Revenue leaks at the handoffs. An eligibility check that misses a plan change leads to a denial weeks later. An authorization that arrives late stalls the claim. A short payment that nobody compares to the contract becomes lost revenue. Qualigenix puts all eight stages of the cycle under one team, so a problem found at one stage gets fixed where it started. Indiana is also changing how often some patients' coverage gets checked, which puts more weight on the front end. We cover that below. Qualigenix also offers Indiana medical billing services, Indiana medical coding services and credentialing services for Indiana providers.
What revenue cycle management services does Qualigenix provide in Indiana?
Qualigenix handles eligibility and benefits checks, prior authorizations, coding, billing, payment posting, denial management, A/R follow-up and credentialing for Indiana practices.
One team works your IHCP, Medicare and commercial accounts, and every stage is measured in a monthly report by payer.
Indiana RCM Problems We Solve
Indiana practices lose revenue at four points in the cycle: eligibility and authorization before the visit, claims filed after a payer's window, payments that arrive late or short, and patient balances billed without the right estimates. Qualigenix works all four.
Eligibility and Authorization First
Qualigenix checks IHCP eligibility through the state's Eligibility Verification System before each visit, along with Medicare and commercial coverage. From January 1, 2027, many HIP members face work requirements and eligibility reviews every six months, so coverage can change between visits. On authorizations, Indiana law gives state-regulated commercial plans 24 hours for urgent requests and 48 hours for standard ones, weekends and holidays excluded, and IHCP managed care plans have worked to the same clock since July 1, 2025. We submit each request electronically through prior authorization and track it to that clock.
Claims Inside Every Window
IHCP allows 180 days from the date of service for fee-for-service claims, and its managed care plans hold in-network providers to 90 days. Medicare claims processed by Wisconsin Physicians Service, Indiana's Medicare contractor, must be filed within 12 months. Qualigenix tracks each claim by payer and date of service, so the oldest claims get filed first.
Payments Tracked to Deadlines
Indiana insurers must pay or deny a clean claim within 30 days when filed electronically and 45 days on paper, with interest starting on day 31 or day 46. IHCP requires its payers to process clean claims within 21 days when filed electronically and 30 days on paper. Qualigenix posts every payment against those timelines and the expected amount through payment posting, then follows up on anything late or short.
Patient Balances Billed Right
Indiana patients can request a good faith estimate before scheduled, non-emergency care, and federal surprise billing rules protect them from out-of-network bills for emergency care. Qualigenix bills patients only for balances their plan's explanation of benefits supports. Statements use plain language, and payment plans spell out the terms.
PROVEN RCM PERFORMANCE
Results Indiana Practices Can Expect
The figures below are company-wide results across Qualigenix client practices, not Indiana-only numbers. They come from tracking every stage of the cycle for the same accounts.
98%
Claim accuracy
4.8%
Denial rate
97.7%
Net collections rate
54 → 36
Days in A/R
Reduced to 38%
A/R over 90 days
79%
Denials overturned
29-32%
Cash-flow improvement
$1.6B+
Total charges handled
$923M+
Accounts receivable recovered
1,400+
Providers set up nationally
PROVEN TRACK RECORDHIPAA-Compliant Revenue Cycle
275+ Clinics6-DAY ONBOARDING
How Onboarding Works
Qualigenix takes most Indiana practices live in six days, in four steps.
01
Onboarding Call First
We review your current billing setup, payer mix and denial trends, and agree on which stages of the cycle Qualigenix takes over. You'll know who your team is from the first call.
02
Software and Portal Setup
Qualigenix sets up access inside your existing EHR, clearinghouse and payer portals, including the IHCP Provider Healthcare Portal and managed care plan portals. You keep the software you already use.
03
Accounts Cleaned Up First
We check payer enrollments, fee schedules and open A/R, fix demographic errors and build the rules your claims will run through.
04
Live by Day Six
Qualigenix takes over daily operations by day six. Legacy A/R gets worked in parallel, so cash keeps coming in during the handoff.
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WHY INDIANA PRACTICES CHOOSE QUALIGENIX
Why Indiana Practices Choose Qualigenix
One team managing every stage from eligibility through A/R, operating inside your EHR with payer-level transparency.
One Team, Every Stage
Eligibility, authorization, coding, billing, posting, denials and A/R sit with one Qualigenix team. When a denial traces back to a missed authorization, the fix happens at the front desk process, not just on the claim.
Any EHR Works
Qualigenix has worked in 133 EMR and EHR platforms. We run your cycle inside the system you already have, with no migration.
Payer-Level Monthly Reports
Your monthly report breaks collections, denials and days in A/R out by payer, so you can see how IHCP plans, WPS and each commercial carrier are paying.
Running in Six Days
Qualigenix's average onboarding takes six days. Legacy balances get worked from week one, so cash flow stays steady through the switch.
INDIANA RCM FAQS
Frequently Asked Questions
Common questions regarding IHCP prior authorization turnaround, timely filing windows, WPS Medicare handling, and RCM onboarding in Indiana.
Qualigenix runs revenue cycle management for independent practices across Indiana in 38+ specialties. One team handles eligibility through A/R for IHCP, Medicare and commercial payers. Book a meeting with a revenue cycle specialist to review your cycle.
Qualigenix RCM covers eight services: insurance verification and benefits, prior authorizations, medical coding, medical billing, payment posting, denial management, A/R recovery and credentialing. Practices can hand over the full cycle or start with selected stages.
Yes. Qualigenix submits authorization requests electronically to IHCP managed care plans, Medicare Advantage plans and commercial payers, then tracks each one against the plan's decision window. Missing records are sent before the deadline passes.
Qualigenix files IHCP fee-for-service claims within 180 days and managed care claims within each plan's limit, usually 90 days. Medicare claims go to Wisconsin Physicians Service within 12 months. Crossover claims for dual-eligible patients are followed until paid.
Qualigenix sends clean claims the first time, follows up on unpaid claims every business day and appeals denials with root-cause fixes. Across client practices, that approach has reduced days in A/R from 54 to 36.
Qualigenix charges a percentage of collections, so our fee depends on what your practice collects. The percentage reflects your specialty, volume and the services in scope. A revenue cycle specialist can explain the terms in a short meeting.
Qualigenix's average onboarding takes six days. We work your legacy A/R alongside new claims during the switch, so there's no gap in collections, and you keep your current EHR.
Yes. Qualigenix signs a business associate agreement with every practice and works inside your systems under access controls. Patient data stays protected under HIPAA at every stage of the revenue cycle.