Revenue Cycle Management Services
in Indianapolis, IN

Qualigenix runs the revenue cycle for Indianapolis practices, from the eligibility 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 Indianapolis Practices

Qualigenix revenue cycle management covers independent practices across Indianapolis and Marion County that want one team accountable from scheduling to payment. Statewide rules, including Traditional Medicaid filing limits and Indiana's prompt-pay law, are on our RCM services in Indiana page. This page covers the revenue cycle problems specific to a Marion County payer mix: Medicaid plan changes, eligibility churn and authorization deadlines that differ by payer. Qualigenix works with all payers. Your account gets a dedicated team that 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 Indianapolis?

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

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

RCM for Marion County's Medicaid Plans

Qualigenix handles eligibility, authorizations and claims for each Indiana Medicaid plan an Indianapolis practice sees. Medicaid managed care in Indiana runs statewide through four programs, and since January 1, 2026, the plan roster is Anthem, CareSource and Managed Health Services (MHS) for HIP and Hoosier Healthwise, Anthem, MHS and UnitedHealthcare for Hoosier Care Connect, and Anthem, Humana and UnitedHealthcare for PathWays for Aging.

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Eligibility Checked Every Visit

MDwise left HIP and Hoosier Healthwise on January 1, 2026, so its members moved to new plans while keeping the same IHCP member ID. More change is coming: from January 1, 2027, HIP members must report 80 hours a month of work, school, training or volunteering, and FSSA will renew HIP eligibility every six months. Coverage that was active at the last visit may not be active at the next one, so we check the IHCP Eligibility Verification System and the plan before every appointment.

Authorizations Tracked by Plan

Since January 1, 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 submit each request to the member's plan, log the decision deadline and follow up the day it passes, so services aren't delayed by a request that stalled.

Statewide Indiana RCM Rules

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

Medicare and Commercial Payers for Indianapolis 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. Indiana sets its own rules for commercial plans. Insurers must decide urgent prior authorization requests within 48 hours and nonurgent requests within five business days, and generally can't revoke an approval if the service starts within 45 business days. Clean electronic claims must be paid or denied within 30 days, paper claims within 45, with interest owed after that. We track each commercial claim against those dates and push payers that pass them.

PROVEN RCM PERFORMANCE

Results Indianapolis Practices Can Expect

These are company-wide results across Qualigenix client practices, not Indianapolis-only figures. Each one 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 transitions Indianapolis practices live onto our revenue cycle management platform in six days on average through a structured four-step process.

Onboarding Call and Plan

We review your billing setup, denial trends by payer and where revenue is slipping, then build a plan for your Indiana payer mix. The BAA is signed before we access any data.

Software and Portal Setup

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

Account Clean-Up Work

Specialists handle verification, coding, claim scrubbing, open denials and posting backlog, so live work starts from a clean set of accounts.

Live by Day Six

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

WHAT WE DO

Specialized RCM Solutions in Indianapolis

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VERIFICATION

VERIFICATION/01

Coverage Confirmed Upfront

Insurance verification and benefits checks run before each visit against the member's current Indiana Medicaid plan, Medicare or commercial coverage, so eligibility gaps surface at the front desk.

PRIOR AUTH

PRIOR AUTH/02

Approvals Before Service Dates

Prior authorizations are requested from the right plan and tracked to Indiana's 48-hour and five-business-day commercial deadlines or the Medicaid 72-hour and seven-day limits.

CODING

CODING/03

Certified Coders Assigned

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

BILLING

BILLING/04

Charges Through Payment

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

POSTING

POSTING/05

Payments Matched to Claims

Payment posting matches each payment to its claim and flags underpayments against IHCP's 2026 physician fee schedule, which MCEs must mirror.

DENIALS

DENIALS/06

Denials Fixed at Source

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

A/R RECOVERY

A/R RECOVERY/07

Unpaid Claims Followed Daily

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

CREDENTIALING

CREDENTIALING/08

Enrollment Kept Active

Credentialing keeps every provider enrolled with IHCP, each Medicaid plan, WPS and commercial payers, including IHCP revalidation notices.

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WHY INDIANAPOLIS PRACTICES CHOOSE QUALIGENIX

Why Indianapolis Practices Choose Qualigenix

One accountable team managing eligibility through payment directly inside your EHR with payer-level reporting and 6-day onboarding.

One Team, Every Stage

One team handles eligibility through payment. When a claim denies, the people who verified coverage and coded the visit are the same people who fix it.

Any EHR Platform

Qualigenix has worked in 133 EMR and EHR platforms and sets up inside yours. Your staff keeps its workflow, and no data moves to a new system.

Monthly Reporting by Payer

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

Live in Six Days

Onboarding takes six days on average. Legacy A/R is worked alongside new claims, so the transition doesn't stall cash flow.

INDIANAPOLIS RCM FAQS

Frequently Asked Questions

Common questions regarding Marion County Medicaid plans, 2027 HIP work requirements, prior authorization rules, and RCM onboarding in Indianapolis.

Qualigenix manages the revenue cycle for independent practices across Indianapolis and Marion County. When you compare companies, ask whether one team covers eligibility through payment, how each tracks Indiana Medicaid plan 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 works all eight inside your EHR and reports results by payer every month.

From January 1, 2027, many HIP members must report 80 hours a month of qualifying activity, and HIP eligibility will be renewed every six months. More members may lose or change coverage between visits, so we verify eligibility before every appointment to catch gaps early.

Yes. We submit requests to the member's plan, whether Anthem, CareSource, MHS, UnitedHealthcare or Humana, and track each one to the 72-hour urgent or seven-day standard decision deadline that has applied since January 2026.

We check eligibility and authorizations before the visit, submit 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 bucket.

No. Results depend on a team that knows Indiana Medicaid plans, WPS Medicare and Indiana's commercial payment rules, and that works inside your EHR. Qualigenix reports by payer every month, so you can judge performance on the numbers.

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 walk you through it.

Revenue Cycle Management Services in Indianapolis, IN