Revenue Cycle Management Services
in Fort Wayne, IN

Qualigenix runs the revenue cycle for Fort Wayne practices, from the coverage check before a visit to the posted payment, across Indiana Medicaid plans, Medicare and commercial insurers. Talk to a revenue cycle specialist at 786-259-0231. We sign a HIPAA business associate agreement before we access your systems.

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How Qualigenix Serves Fort Wayne Practices

Qualigenix revenue cycle management covers independent practices in Fort Wayne and across Allen County that want one team responsible from scheduling to payment. Traditional Medicaid filing limits, Indiana's prompt-pay law and other statewide rules are on our RCM services in Indiana page. This page covers the revenue cycle problems a Fort Wayne payer mix brings: HIP members facing new work rules, Ohio patients with a second state's coverage, and authorization deadlines that differ by payer. Qualigenix works with all payers. Your team sets up inside your EHR and reports results by payer every month.

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What revenue cycle management services does Qualigenix provide in Fort Wayne?

Qualigenix covers every stage of the revenue cycle for Fort Wayne practices: insurance verification, prior authorizations, medical coding, billing, payment posting, denial management, A/R recovery and credentialing. One team runs all eight inside your existing EHR for Indiana Medicaid, Medicare and commercial payers.

You pay a percentage of collections and get a monthly report showing where revenue moved by payer.

RCM for Allen County's Medicaid Plans

Qualigenix handles eligibility, authorizations and claims for each Indiana Medicaid plan a Fort Wayne practice sees. Since January 1, 2026, HIP and Hoosier Healthwise run through Anthem, CareSource and Managed Health Services (MHS), Hoosier Care Connect through Anthem, MHS and UnitedHealthcare, and PathWays for Aging through Anthem, Humana and UnitedHealthcare.

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HIP Work Rules Coming

From January 1, 2027, most HIP members ages 19 to 64 must log 80 hours a month of work, school, training or volunteering, or earn at least $580 a month. FSSA will renew HIP every six months and check hours every three months, and January applicants must show the hours for October through December 2026. Coverage that was active last visit may lapse before the next, so we check the IHCP Eligibility Verification System before every appointment.

Authorizations Logged by Deadline

Since January 2026, Indiana Medicaid and its managed care plans must decide urgent prior authorization requests within 72 hours and standard requests within seven calendar days. We send each request to the member's current plan, log its deadline and follow up when that date passes without an answer.

Statewide Indiana RCM Rules

Traditional Medicaid filing exceptions, commercial prompt-pay interest and other statewide rules are on our Indiana revenue cycle rules page.

Medicare and Commercial Payers for Fort Wayne Practices

Qualigenix sends Traditional Medicare claims to Wisconsin Physicians Service (WPS), the Jurisdiction 8 contractor for Indiana and Michigan, and Medicare Advantage claims to each plan, including the PathWays Dual Care plans from Anthem, Humana and UnitedHealthcare. Medicare routes a claim by where the service happened, so a Fort Wayne visit goes to WPS even for a patient who lives in Ohio. Ohio Medicaid works differently: it generally pays only providers enrolled with the Ohio Department of Medicaid, so we confirm a payable route before an Ohio Medicaid patient's visit. Indiana sets its own commercial rules. Insurers must decide urgent prior authorization requests within 48 hours and nonurgent requests within five business days. Clean electronic claims must be paid or denied within 30 days and paper claims within 45, with interest owed after that. We track every commercial claim against those dates.

PROVEN RCM PERFORMANCE

Results Fort Wayne Practices Can Expect

These are company-wide results across Qualigenix client practices, not figures for Fort Wayne alone. Each is defined in your monthly report, so you can follow the same measure for your practice.

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

$923M+

Accounts receivable recovered

1,400+

Providers set up nationally

Medical Billing Performance and Analytics

PROVEN TRACK RECORDHIPAA-Compliant Revenue Cycle

275+ Clinics

6-DAY ONBOARDING

How Onboarding Works

Qualigenix brings Fort Wayne practices live on our revenue cycle platform in six days on average, with old backlog cleared and systems connected.

Discovery Call First

We review your billing setup, denial trends by payer and where revenue is leaking, then plan the work around your Indiana and Ohio payer mix. The BAA is signed before we see any data.

Systems and Portals Connected

We set up inside your existing EMR or EHR, connect to the IHCP and plan portals you use, and learn your front-desk steps.

Old Backlog Cleared

Specialists work through verification gaps, coding issues, open denials and unposted payments, so live work starts from clean accounts.

Running by Day Six

Your revenue cycle runs live with Qualigenix by day six on average. Payments usually start arriving within three weeks, and monthly reporting by payer begins.

WHAT WE DO

Specialized RCM Solutions in Fort Wayne

See All Services

VERIFICATION

VERIFICATION/01

Coverage Checked at Scheduling

Insurance verification and benefits checks run against each patient's current Indiana Medicaid plan, Ohio Medicaid, Medicare or commercial coverage before the visit.

PRIOR AUTH

PRIOR AUTH/02

Approvals Secured Early

Prior authorizations go to the right plan and are tracked to Indiana's commercial deadlines or the Medicaid 72-hour and seven-day limits.

CODING

CODING/03

Coding by Certified Staff

Medical coding by CPC- and CCS-certified coders uses FY 2027 ICD-10-CM codes, in effect since October 1, 2026, and each plan's policies.

BILLING

BILLING/04

Claims Built and Sent

Medical billing covers charge capture through submission, with each Indiana Medicaid claim routed to the plan that covered the member that day.

POSTING

POSTING/05

Payments Reconciled to Claims

Payment posting matches each payment to its claim and flags anything paid below IHCP's 2026 physician fee schedule, which Indiana's Medicaid plans must mirror.

DENIALS

DENIALS/06

Denials Traced and Fixed

Denial management finds why each claim denied, corrects and resubmits it, and sends the cause back to the front desk or coders.

A/R RECOVERY

A/R RECOVERY/07

Aging Claims Chased Daily

AR recovery follows every open claim until it's resolved, including MDwise claims for 2025 dates of service.

CREDENTIALING

CREDENTIALING/08

Providers Kept Enrolled

Credentialing keeps each provider active with IHCP, every Medicaid plan, WPS and commercial payers, and with Ohio Medicaid where needed.

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WHY FORT WAYNE PRACTICES CHOOSE QUALIGENIX

Why Fort Wayne Practices Choose Qualigenix

One team managing every stage from front-desk verification through reimbursement, inside your existing EHR with zero software change.

Same Team Throughout

The people who verify coverage and code the visit also fix the denial. Nothing gets passed between vendors, and one team answers for the result.

Works in Any EHR

Qualigenix has worked in 133 EMR and EHR platforms and sets up inside yours. Staff keep their workflow, and your data stays where it is.

Reports by Payer

Your monthly report breaks down collections, denials and A/R by payer, including each Indiana Medicaid plan, with a definition for every number.

Live Within a Week

Onboarding takes six days on average. Legacy A/R is worked while new claims go out, so cash flow doesn't stall during the change.

FORT WAYNE RCM FAQS

Frequently Asked Questions

Frequently asked questions regarding Allen County Medicaid plans, 2027 HIP work requirements, Ohio cross-border coverage, and RCM onboarding in Fort Wayne.

Qualigenix manages the revenue cycle for independent practices across Fort Wayne and Allen County. When you compare companies, ask whether one team covers eligibility through payment, how each tracks Indiana Medicaid changes and how results are reported. Talk to a revenue cycle specialist at 786-259-0231.

It includes insurance verification and benefits, prior authorizations, medical coding, medical billing, payment posting, denial management, A/R recovery and credentialing. One team runs all eight inside your EHR and reports by payer every month.

From January 1, 2027, most HIP members must show 80 hours a month of qualifying activity, with renewals every six months and hour checks every three. More patients may lose or change coverage between visits, so we verify eligibility before every appointment.

We check before the visit whether your practice is enrolled with the Ohio Department of Medicaid or whether the patient's Ohio plan will pay under a single case agreement. If neither applies, you know before the service, not after a denial.

We check eligibility and authorizations before the visit, send clean claims daily and follow up on open claims every day. Across client practices, days in A/R fell from 54 to 36. Your monthly report shows A/R by payer and age.

No. Results depend on a team that knows Indiana's Medicaid plans, WPS Medicare, Ohio cross-border rules and Indiana's commercial payment rules, and that works inside your EHR. Qualigenix reports by payer monthly, so you can judge the numbers yourself.

Qualigenix charges a percentage of collections, so our fee is tied to what your practice collects. The percentage depends on your specialty, volume and payer mix, and we set it after reviewing your practice. A revenue cycle specialist can explain it.

Revenue Cycle Management Services in Fort Wayne, IN