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Radiology Billing Services in Indiana

Indiana is phasing MDwise out of the Healthy Indiana Plan and Hoosier Healthwise on January 1, 2026, after the state cited it as the costliest and lowest-quality plan it ran. Roughly 300,000 members are being reassigned to Anthem, CareSource, or Managed Health Services. A claim still routed to MDwise doesn’t get flagged, it gets rejected. RBS rebuilt its Indiana process around which Medicaid plan each patient is actually assigned to, from Jurisdiction 8 Medicare edits to Anthem’s commercial rules.

An Indiana Medicaid Plan Just Got Phased Out. Has Your Biller Noticed?

Indiana didn’t tweak a form, it removed a managed care entity covering roughly 300,000 Hoosiers outright. MDwise exits the Healthy Indiana Plan and Hoosier Healthwise on January 1, 2026, leaving claims built around its assignment with nowhere to land. Add Anthem’s dominant hold on the commercial market, and a claim built on last year’s plan list starts breaking fast.

Confirm every Indiana Medicaid claim is routed to a plan that's still actually active

Track Managed Health Services' Indiana-only rules apart from Anthem's larger commercial footprint

Apply Indiana's 30-day electronic and 45-day paper deficiency-notice clock correctly, every claim

Keep TC/PC splits accurate across a Medicare jurisdiction spanning two Midwest states

Processed Claim Value
$ M+
Avg. A/R Collection Time
0 Days
Turn Around Time (TAT)
0 Hours
Client Retention Rate
0 %
Annual Claims
0 M+
First-Pass Claim Rate
0 %
Avg. Revenue Growth
8- 8 %
Avg. Denial Reduction
0 %

Four Reasons Indiana Claims Get Denied Now

A Medicaid shake-up this size hides a lot of ways a clean claim goes sideways. Here’s exactly where it costs you.

One Contractor, Two Midwest States

Jurisdiction 8, run by WPS Government Health Administrators, covers Indiana alongside Michigan, a two-state Medicare contractor rather than a single-state one. A rule tuned for that combined two-state mix doesn’t always fit Indiana’s own claim patterns and provider base precisely. RBS tracks Jurisdiction 8’s Indiana-specific guidance on its own, so a two-state assumption never gets applied here.

A Medicaid Plan That's Being Phased Out

Indiana is phasing MDwise out of Hoosier Healthwise and the Healthy Indiana Plan on January 1, 2026, after the state cited it as the costliest, lowest-quality plan it ran. Roughly 300,000 members are reassigned to Anthem, CareSource, or Managed Health Services. A claim still routed to MDwise doesn’t get flagged, it gets rejected. RBS tracks which Indiana Medicaid plan each patient is actually assigned to.

A Newer Compact Member Since 2023

Indiana’s Interstate Medical Licensure Compact pathway went live on July 5, 2023, a newer addition compared to states that have run the process since 2016. Mainland radiologists reading Indiana studies under this newer pathway can’t assume an established member’s turnaround times apply. RBS plans around Indiana’s shorter compact history instead of assuming it moves like a founding state member.

One Insurer, One Deficiency Clock

Anthem has long controlled the largest share of Indiana’s commercial insurance market, a position reinforced by its past bid to absorb Cigna’s book of business. Indiana Code 27-8-5.7-5 requires insurers to flag a claim deficiency within 30 days electronic or 45 days paper, or it’s deemed clean and payable. Managed Health Services, Centene’s Indiana-only plan, runs separate rules. RBS tracks both together.

Complete Radiology Revenue Cycle Management

Certified CIRCC and CPC coders handle every CPT code, modifier, and global billing rule specific to diagnostic and interventional radiology — maximizing reimbursement on every encounter across all modalities and payer types.

What Changes When RBS Takes This Off Your Plate

Radiology billing isn’t generalist RCM. The TC/PC splits, the review clocks, the LCD churn are specialty-specific. Here’s the shift practices see once RBS steps in for an Indiana group adjusting to a Medicaid managed-care reshuffle, a commercial market with one dominant carrier, and a state where 7.5% of residents still carry no insurance at all (America’s Health Rankings, 2024).

Before RBS

Staffing costs run $60K to $90K a year, hard to justify in a competitive market

Denial rates sit at 20 to 35%, often tied to a plan that no longer qualifies

One staff member's day off and claims processing grinds to a halt

Manual data entry mistakes cost more than the imaging scan itself

A missed plan reassignment sends the claim back weeks later, unpaid

After RBS

Performance-based pricing, RBS earns only when your practice collects

98%+ first-pass clean claim rate, checked against active Indiana plans

365 days a year, 24/7 revenue cycle coverage, with zero staffing gaps

AI-OCR reads every superbill, EOB, and ERA the moment it arrives

Every claim billed against Indiana's current Medicaid assignment, not last year's

Precision RCM & Coding Built for Radiology

Generic billing is the fastest way to a denied radiology claim. RBS delivers specialty-specific revenue integrity built for imaging’s TC/PC splits and modifier rules, so you capture every dollar you’re owed.

Diagnostic Radiology

CT Scan

MRI & MRA

Nuclear Medicine

PET / PET-CT

Ultrasound

Interventional Radiology

Teleradiology

Mammography

DEXA / Bone Density

Hospital Radiology

Radiation Oncology

Coverage Confirmed for Every Payer You Work With

From national carriers to regional Medicaid plans, coverage is checked against the exact payer, plan, and product type on file — never a generic match. Every result reflects current payer policy, not outdated data from months ago.
medicare
Medicaid
Molina health
Ambetter health
cigna
Elevance Health (Anthem)
United healthcare
aetna
Blue cross Blue shield
OSCAR health
Health Net
Kaiser Permanente
tricare
wellcare
Humana
medicare
Medicaid
Molina health
Ambetter health
cigna
Elevance Health (Anthem)
United healthcare
aetna
Blue cross Blue shield
OSCAR health
Health Net
Kaiser Permanente
tricare
wellcare
Humana
medicare
Medicaid
Molina health
Ambetter health
cigna
Elevance Health (Anthem)
United healthcare
aetna
Blue cross Blue shield
OSCAR health
Health Net
Kaiser Permanente
tricare
wellcare
Humana

From Indianapolis to Evansville, Billed on Current Facts

A denial in Indianapolis and a denial in Southern Indiana rarely share a cause: different Medicaid plan assignment, different referral patterns, different distance to specialists. RBS bills each Indiana area the way its own provider network actually works, not a single statewide guess.

Indianapolis Metro

Cities
  • Indianapolis
  • Carmel
  • Fishers
Counties
  • Marion County
  • Hamilton County

Northwest Indiana

Cities
  • Gary
  • Hammond
  • Merrillville
Counties
  • Lake County
  • Porter County

Northeast Indiana

Cities
  • Fort Wayne
  • Auburn
  • Huntington
Counties
  • Allen County
  • DeKalb County

North Central Indiana

Cities
  • South Bend
  • Elkhart
  • Mishawaka
Counties
  • St. Joseph County
  • Elkhart County

Southern Indiana

Cities
  • Evansville
  • New Albany
  • Jeffersonville
Counties
  • Vanderburgh County
  • Clark County

East Central Indiana

Cities
  • Muncie
  • Anderson
  • Richmond
Counties
  • Delaware County
  • Madison County

Wired Into Every System You Already Run

Your EHR, RIS, and PACS stay exactly as they are. We plug our coding workflow directly into what you already use — no migration, no new login for your radiologists, no disruption to how your team already works.

Indiana Runs on Rules Built for Indiana. So Does Every Other State We Bill.

A claims team working off last year’s Medicaid plan list misses that MDwise exits the Healthy Indiana Plan on January 1, 2026, and the gap between Anthem’s dominant footprint and Managed Health Services’ Indiana-only rulebook. Our specialists train on Indiana’s actual, current payer structure, not a generic script, so a phased-out plan mismatch is never the reason a claim gets denied.
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Frequently Asked Questions

Which Medicare contractor processes radiology claims in Indiana?

WPS Government Health Administrators, under Jurisdiction 8, which also covers Michigan rather than Indiana alone.
MDwise is being phased out of the Healthy Indiana Plan and Hoosier Healthwise effective January 1, 2026, after the state cited it as the costliest, lowest-quality managed care entity it ran. Roughly 300,000 members are being reassigned to Anthem, CareSource, or Managed Health Services.
Yes, Indiana’s compact pathway went live on July 5, 2023, a newer addition compared to founding states that have run the process since 2016.
Indiana Code 27-8-5.7-5 requires insurers to notify providers of a claim deficiency within 30 days for electronic claims or 45 days for paper claims, or the claim is automatically deemed clean and payable.
Every claim is checked against the Medicaid plan a patient is actually currently assigned to, not the plan they were on before MDwise’s exit, alongside Anthem’s separate commercial rules.

Whichever Indiana Office Files It, RBS Gets It Paid

Somewhere in your outstanding claims right now, there’s a clean scan sitting unpaid because it was billed against a Medicaid plan phased out of Indiana on January 1, 2026, or the wrong side of Anthem’s concentrated commercial share. Across the practices we review, that adds up to 5 to 10% of collectible revenue, aging quietly by the day. RBS finds it, recovers it, and builds a process that stops it from recurring. Start with a free audit, no commitment, just a clear answer on what’s actually recoverable before you decide anything.

No setup fee. No monthly minimum.

Cancel anytime.

Response within 24 hours.

Pay only a percentage of what we collect for you.

Free claims and A/R audit before you commit to anything.

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What Our Clients Say?

Rebecca Lawson

★★★★★

Radiology Practice Manager

Since partnering with your radiology billing team, our billing workflow has become much smoother. They understand imaging procedures, payer requirements, coding, and claim follow-ups. Their team is responsive, professional, and always stays on top of outstanding claims.

Dr. Christopher Bennett

★★★★★

Medical Director, Diagnostic Imaging Center

Your team truly understands the challenges of radiology billing. They handle claims accurately, follow up on unpaid accounts, and help resolve billing issues efficiently. Their expertise and communication have made our revenue cycle more organized and reliable.

Dr. Andrew Whitaker

★★★★★

Radiologist & Imaging Center Owner

Our team has been an excellent partner for our imaging center. They understand radiology billing, coding, claim submission, denials, and follow-ups. Their attention to detail and consistent communication have helped streamline our billing process and improve our revenue cycle.

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