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Revenue Cycle Management Services
in Evansville, IN
Qualigenix runs the revenue cycle for Evansville practices from the eligibility check to the posted payment, with one team accountable for every step. We sign a HIPAA business associate agreement before any patient data moves.
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How Qualigenix Serves Evansville Practices
Qualigenix runs revenue cycles for Evansville practices whose patients carry five Indiana Medicaid managed care companies, Original Medicare, Medicare Advantage and commercial plans, plus Kentucky coverage for patients who cross the river. With that many payers, front-end errors such as an expired plan, a missed authorization or the wrong payer on the claim are where we put the most checks. Rules that apply across Indiana, from Medicaid filing limits to prompt-payment timelines, are covered on our revenue cycle management services in Indiana page. This page covers what changes for an Evansville practice. We support 38+ specialties and bill all payers.
What Revenue Cycle Management Services Does Qualigenix Provide in Evansville?
Qualigenix revenue cycle management gives Evansville practices eight connected services under one team: insurance verification, prior authorization, medical coding, medical billing, payment posting, denial management, A/R recovery and credentialing.
We work with all payers, including Indiana Medicaid plans, Medicare and commercial insurers, inside your current EHR. Pricing is a percentage of collections.
Revenue Cycle Management for Vanderburgh County's Medicaid Plans
Qualigenix checks eligibility, secures authorizations and routes claims to the right Indiana Medicaid plan for each Evansville patient. Vanderburgh County members choose from the same statewide plans as the rest of Indiana: Anthem, CareSource and MHS for HIP and Hoosier Healthwise since January 1, 2026; Anthem, MHS and UnitedHealthcare for Hoosier Care Connect; and Anthem, Humana and UnitedHealthcare for PathWays for Aging.
Eligibility Checked Every Visit
Starting January 1, 2027, HIP members ages 19 to 64 who aren't exempt must show 80 hours a month of work, school, volunteering or a work program to keep coverage, and HIP renewals move from once a year to every six months. A patient covered in March may not be covered in May. Qualigenix checks eligibility and the plan of record before every visit, so a lapse shows up before the claim does.
Authorizations Routed Correctly
Each Medicaid managed care plan handles prior authorization for its own members, so a request sent to the wrong plan stalls. Since 2026, Indiana Medicaid and its managed care plans must decide standard requests within seven calendar days and urgent ones within 72 hours. Practices with a service location in Henderson County, Kentucky, count as in-state for fee-for-service Medicaid prior authorization, so they skip the extra out-of-state approval step.
Statewide Revenue Cycle Rules
Indiana Medicaid's fee-for-service filing limits, retroactive eligibility extensions and appeal steps apply the same way in every county. We cover them in Indiana revenue cycle rules for independent practices.
Medicare and Commercial Payers for Evansville Practices
Qualigenix sends Original Medicare claims for Evansville practices to WPS Government Health Administrators, the Medicare contractor for Indiana, within Medicare's 12-month filing limit. Medicare Advantage plans must also meet the 72-hour and seven-day prior authorization deadlines that began in 2026. For patients 60 and older in PathWays Dual Care, one Anthem, Humana or UnitedHealthcare plan covers both Medicare and Medicaid, so eligibility, authorization and the claim all run through that plan. For commercial plans regulated by Indiana, state rules call for prior authorization answers within 24 hours on urgent requests and 48 hours on others, and a new plan must honor an existing authorization for at least the first 90 days of coverage. We track each request to those clocks. Kentucky Medicaid pays only enrolled providers, so we confirm enrollment before billing it.
PROVEN RCM PERFORMANCE
Results Evansville Practices Can Expect
The figures below are company-wide results across Qualigenix client practices, not Evansville-only numbers. They come from running the eight services above as one revenue cycle.
98%
Claim accuracy rate
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 over an Evansville practice's revenue cycle in four steps, and most practices are live within six days.
01
Onboarding Call First
We review your billing setup, denial trends and payer mix, then build a plan around where revenue is leaking today.
02
Software and Portal Setup
Our team works inside your existing EMR or EHR and payer portals, and learns your specialty's standard procedures.
03
Full Account Clean-Up
Specialists clear eligibility gaps, coding issues, claim edits, open denials and unposted payments before new volume arrives.
04
Live by Day Six
Your revenue cycle runs live with Qualigenix by day six on average, and older A/R is worked in parallel.
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WHY EVANSVILLE PRACTICES CHOOSE QUALIGENIX
Why Evansville Practices Choose Qualigenix
One team end-to-end, seamless operation inside any EHR, monthly reports by payer, and rapid six-day onboarding.
One Team End-to-End
Eligibility, authorization, coding, billing, posting, denials, A/R and credentialing sit with one Qualigenix team. When a denial traces back to the front desk, the same team fixes both ends.
Any EHR Works
We work inside the EMR or EHR you already use. Qualigenix has experience across 133 platforms, so there's no software change and no data migration.
Monthly Reports by Payer
You get monthly reporting broken out by payer: collections, denial rate, days in A/R and aging. Each figure carries its definition, so you know what you're reading.
Live in Six Days
Onboarding averages six days, and older A/R keeps moving during the switch. Payment usually lands within three weeks of go-live.
EVANSVILLE RCM FAQS
Frequently Asked Questions
Frequently asked questions regarding Vanderburgh County Medicaid plans, 2027 HIP work requirements, prior authorization turnaround, and RCM onboarding in Evansville.
Qualigenix runs revenue cycles for Evansville practices across all payers, including every Indiana Medicaid plan, WPS for Medicare and commercial insurers. When you compare RCM companies, ask whether one team owns every step and how results are reported by payer. Qualigenix reports a 97.7% net collections rate.
It includes insurance verification, prior authorization, medical coding, medical billing, payment posting, denial management, A/R recovery and credentialing, all run by one team. Patient billing and monthly reporting by payer are part of the service too. A revenue cycle specialist can show which pieces your practice needs.
Yes. Qualigenix submits and tracks prior authorizations with each Indiana Medicaid plan, Medicare Advantage plans and commercial payers. Medicaid plans and Medicare Advantage plans must decide standard requests within seven calendar days and urgent ones within 72 hours, and we follow each request to that deadline.
From January 1, 2027, many HIP members must report 80 hours a month of work or other qualifying activity, and renewals move to every six months. More patients may lose coverage between visits. Qualigenix checks eligibility before every appointment so lapses are caught before the claim.
Qualigenix cuts A/R days by preventing denials at the front end, scrubbing claims before submission and following up on unpaid claims daily by payer and age. Across client practices, days in A/R dropped from 54 to 36 on average. A revenue cycle specialist can review your aging report.
Qualigenix charges a percentage of collections for revenue cycle management, so our fee moves with your payments. The rate depends on your specialty, volume and payer mix. A revenue cycle specialist can give you a quote after reviewing your numbers.
No. Revenue cycle results depend on knowing Indiana's Medicaid plans, WPS Medicare rules and your commercial contracts, and on working inside your EHR and payer portals. Qualigenix runs Evansville revenue cycles to those rules and reports by payer every month.