Medical Billing Services in Indiana
Indiana built its own version of Medicaid expansion, the Healthy Indiana Plan, with POWER accounts and rules found nowhere else. We bill IHCP's programs and Anthem's home-state market every day.
Get a Free IN Revenue AnalysisPRMS Billing Solutions runs complete billing and revenue cycle management for Indiana providers, from Indianapolis and its suburbs to Fort Wayne, Evansville, South Bend, and rural counties. Indiana's Medicaid programs carry unique structures (HIP's POWER accounts, distinct programs by population), and its commercial market is Anthem's home turf. We handle eligibility, coding, claims, denials, AR, and credentialing across the whole stack.
Medicare billing in Indiana
Indiana Part B claims are processed by WPS Government Health Administrators, the Medicare Administrative Contractor for Jurisdiction 8 (Indiana and Michigan). We file to WPS daily and apply its local coverage determinations during scrubbing. Medicare Advantage in Indiana is led by Anthem, Humana, UnitedHealthcare, and Aetna, and MA status is checked at eligibility before any Medicare claim leaves.
Indiana Medicaid (IHCP) billing
The Indiana Health Coverage Programs (IHCP) umbrella covers several distinct programs: the Healthy Indiana Plan (HIP) for expansion adults (with its POWER account cost-sharing), Hoosier Healthwise for children and pregnant members, and Hoosier Care Connect for aged/blind/disabled members. Managed-care entities include Anthem, MDwise, Managed Health Services (Centene), and CareSource. Program and MCE both matter for routing and cost-sharing, and we verify each before the visit.
Commercial payers we bill in Indiana
Anthem Blue Cross Blue Shield of Indiana dominates the commercial market in its own home state (Anthem's corporate roots are in Indianapolis), joined by UnitedHealthcare, Aetna, Cigna, Humana, and regional employer plans through Encore and other networks. Indiana's large self-funded manufacturing employers add TPA-administered plans we identify and route correctly at eligibility.
Specialties we serve across Indiana
We bill 25+ specialties across Indiana, including its core fields: family medicine, internal medicine, orthopedics, cardiology, pain management, behavioral health, and physical therapy.
Why Indiana practices choose PRMS
Indiana's classic leaks: claims denied because the member's IHCP program (HIP vs Hoosier Healthwise) was never identified, MCE misrouting among Anthem/MDwise/MHS/CareSource, and HIP POWER-account cost-sharing billed wrong. Our eligibility-first workflow identifies program, MCE, and cost-sharing before the visit. Credentialing with IHCP, all MCEs, and Anthem is free for billing clients.
Indiana medical billing FAQs
What is the Healthy Indiana Plan and how does it affect billing?
HIP is Indiana's Medicaid expansion program, with POWER account contributions that change member cost-sharing by tier (HIP Plus vs HIP Basic). Billing correctly requires knowing the member's tier, which we verify at eligibility so patient responsibility is right the first time.
Which Indiana Medicaid MCEs do you bill?
Anthem, MDwise, Managed Health Services (MHS), and CareSource, across HIP, Hoosier Healthwise, and Hoosier Care Connect, verified per member before every visit.
Which Medicare contractor covers Indiana?
WPS Government Health Administrators (Jurisdiction 8) processes Indiana Part B claims, with its coverage policies built into our scrubbing.
Do you work with practices statewide?
Yes. Indianapolis, Fort Wayne, Evansville, South Bend, Bloomington, and rural Indiana, fully remote, inside your existing EHR or PM system.
Related services
Explore our full medical billing & RCM services, denial management, and provider credentialing & payer enrollment (free for billing clients), or browse all 25+ specialties we bill and other states we serve.
See what your Indiana practice is leaving on the table
Get a free, no-obligation revenue analysis. We measure your denial rate, days in AR, and recoverable revenue, specific to your payers.