Medical Billing Services in Indiana
Billing, coding, credentialing and denial management for Indiana practices, with Medicare claims through Wisconsin Physicians Service (WPS) (Jurisdiction J8) and Indiana Medicaid handled by people who know the rules.
Medical billing for Indiana practices
Indiana practices bill a Medicaid program split into four managed care programs under the Indiana Health Coverage Programs (IHCP): Hoosier Healthwise, the Healthy Indiana Plan, Hoosier Care Connect and Indiana PathWays for Aging. Plan line-ups differ by program, and MDwise left HIP and Hoosier Healthwise on January 1, 2026, so many patients changed plans. Indianapolis practices see a heavy Anthem and Medicare Advantage mix, while rural counties rely more on Medicaid and traditional Medicare.
SFA Solutions works with Indiana practices remotely. We bill Medicare Part B through WPS, keep your IHCP enrollment and MCE participation current, and work denials across Anthem, CareSource, MHS, Humana and UnitedHealthcare. Indiana's 180 day fee-for-service filing limit and shorter managed care deadlines leave little room for slow follow-up, so we submit most clean claims within 24 hours.
Indiana at a glance
| Medicare contractor | Wisconsin Physicians Service (WPS), Jurisdiction J8 |
|---|---|
| Medicaid timely filing | 180 days from the date of service for fee-for-service claims; managed care entities set their own, often shorter, limits |
| NP practice authority | Reduced |
| Cities we serve | Indianapolis, Fort Wayne, Evansville, South Bend, Carmel, Fishers, Bloomington, Hammond, Lafayette, Gary |
What Indiana billing involves
These are the programs and rules our team works with for Indiana claims.
Medicare
Wisconsin Physicians Service (WPS) · J8Indiana Part B claims are processed by Wisconsin Physicians Service (WPS) in Jurisdiction J8. Medicare's filing limit is 12 months from the date of service, and appeals start with a redetermination within 120 days of the initial decision.
Indiana Medicaid
Indiana Health Coverage Programs (IHCP), administered by the Family and Social Services Administration: Hoosier Healthwise, Healthy Indiana Plan (HIP), Hoosier Care Connect, Indiana PathWays for Aging and traditional Medicaid
Portal: IHCP Provider Healthcare Portal, with Gainwell Technologies as fiscal agent for fee-for-service claims and provider enrollment
Medicaid managed care
HIP and Hoosier Healthwise are served by Anthem, CareSource and Managed Health Services (MHS). Hoosier Care Connect uses Anthem, MHS and UnitedHealthcare, and Indiana PathWays for Aging uses Anthem, Humana and UnitedHealthcare.
Timely filing
180 days from the date of service for fee-for-service claims; managed care entities set their own, often shorter, limits.
Commercial and Medicare Advantage
Anthem Blue Cross and Blue Shield is the largest commercial carrier in Indiana, followed by UnitedHealthcare, Cigna and Aetna. Humana, UnitedHealthcare and Anthem lead Medicare Advantage enrollment.
Prompt pay law
Indiana Code 27-8-5.7-6 requires insurers to pay or deny clean claims within 30 days for electronic claims and 45 days for paper claims, with interest owed on late payments. Under IC 27-8-5.7-5, insurers must flag deficiencies within the same 30 or 45 day windows or the claim is treated as clean.
Nurse practitioners
Reduced practiceIndiana NPs must keep a collaborative agreement with a physician to prescribe, but they can enroll and bill under their own NPI with Medicare, IHCP and most commercial payers. Keep the collaborative agreement current, since payers can request it during credentialing.
Credentialing
Every provider who serves IHCP members, including those who bill only managed care, enrolls with IHCP through the Provider Healthcare Portal, then contracts and credentials with each MCE. Revalidation is required at least every five years, and IHCP sends notices before the due date. Anthem and most commercial carriers use CAQH ProView, so keep it attested every 120 days.
Billing challenges Indiana practices face
Four programs, different plan line-ups
A patient's program decides which MCEs are possible, and the plan list for Hoosier Care Connect is different from HIP. Billing the right company under the wrong program still denies. We verify program and plan at each visit through the IHCP portal.
Plan changes after MDwise
MDwise stopped serving HIP and Hoosier Healthwise on January 1, 2026, and its members moved to Anthem, CareSource or MHS. Practices that did not update patient insurance after the change are still seeing denials. We clean up payer records and rebill affected claims.
Short managed care filing limits
Indiana MCEs often apply filing limits shorter than the 180 day fee-for-service window. A claim held for a missing modifier or an incorrect rendering NPI can age out. We submit most clean claims within 24 hours and track open claims against each plan's limit.
Our services in Indiana
Medical Billing
Learn moreCredentialing & Payer Enrollment
Learn moreMedical Coding
Learn moreDenial Management
Learn moreA/R Recovery
Learn moreEligibility Verification & Prior Authorization
Learn moreMedical Billing Audit
Learn moreRevenue Cycle Management
Learn moreSpecialties we bill in Indiana
Indiana medical billing questions
What is the timely filing limit for Indiana Medicaid?
IHCP fee-for-service claims must be filed within 180 days of the date of service. Managed care entities set their own limits in provider contracts, often shorter, so check each MCE's provider manual.
Who is the Medicare contractor for Indiana?
Wisconsin Physicians Service (WPS) is the Jurisdiction 8 (J8) A/B MAC for Indiana and Michigan. Enrollment updates go through PECOS, and the WPS portal handles eligibility and claim status.
What happened to MDwise in Indiana Medicaid?
MDwise stopped being a managed care option for HIP and Hoosier Healthwise members on January 1, 2026. Members chose or were assigned to Anthem, CareSource or MHS, so verify the current plan before billing.
How fast do Indiana insurers have to pay clean claims?
Under Indiana Code 27-8-5.7-6, insurers must pay or deny a clean claim within 30 days if filed electronically and 45 days if filed on paper. Late payments carry interest. These rules apply to state regulated plans.
Get a free billing audit for your Indiana practice
We will review your recent claims and denials against Indiana payer rules and show you what can be recovered.
Nearby states
Primary sources
- IHCP: Managed Care Health Plans
- FSSA: End of MDwise Participation in HIP and Hoosier Healthwise
- IHCP Provider Reference Module: Claim Submission and Processing
- Indiana Department of Insurance Bulletin 228: Clean Claims Laws (IC 27-8-5.7)
- Indiana Administrative Code 848 IAC 5: Prescriptive Authority for Advanced Practice Nursing
- CMS: Who Are the MACs
Payer rules change. Last reviewed against the primary sources above on . Confirm current rules with the payer before relying on them.
Request your free practice audit
An RCM specialist typically replies within one business day.