Medical billing for Indiana practices

Medical Billing Services in Indiana

PathWays for Aging is not Hoosier Healthwise. The payer follows the program on the card. The Family and Social Services Administration runs the Indiana Health Coverage Programs. Hoosier Healthwise covers children and pregnant members. The Healthy Indiana Plan covers other adults. PathWays for Aging covers older adults and many members with disabilities. A claim built for the wrong program denies even when the member is Medicaid-eligible.

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What a claim follows in Indiana

PathWays for Aging is not Hoosier Healthwise. The payer follows the program on the card.

Three Indiana programs

The Family and Social Services Administration runs the Indiana Health Coverage Programs. Hoosier Healthwise covers children and pregnant members. The Healthy Indiana Plan covers other adults. PathWays for Aging covers older adults and many members with disabilities. A claim built for the wrong program denies even when the member is Medicaid-eligible.

WPS, Jurisdiction 8

Medicare Part A and Part B for an Indiana practice go to WPS Government Health Administrators, Jurisdiction 8, with Michigan. Illinois uses National Government Services, Jurisdiction 6. Ohio and Kentucky use CGS Administrators, Jurisdiction 15.

Workers' compensation

Indiana is not a no-fault state. A work injury is billed to the employer's carrier under the Worker's Compensation Board of Indiana. It is not an Indiana Health Coverage Programs claim.

Indiana billing starts by naming the program, not by saying Medicaid. PathWays, HIP, and Hoosier Healthwise have different plans and different rules. Medicare is the WPS Jurisdiction 8 file, shared with Michigan and not with Illinois.

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Indiana billing questions

What is PathWays for Aging?

Indiana's managed-care program for older adults and many members with disabilities. It is not Hoosier Healthwise and not the Healthy Indiana Plan.

Where does an Indiana Medicare claim go?

WPS Government Health Administrators, Jurisdiction 8. Ohio uses CGS. Illinois uses National Government Services.

Does an Indiana practice change the fee?

The fee is a percentage of net collections. The written rate follows volume, specialty, and how much of the cycle you hand over. There is no setup fee, and the agreement is month to month. The state is not a surcharge. How pricing is set.