Indiana

Indiana Medicaid Billing for Home Care Agencies

Navigating Indiana’s Medicaid system is no small task, especially with the shift to Managed Care Entities (MCEs) under the Pathways for Aging program. Paradigm is your single, unified platform for billing all Indiana MCEs. Whether you’re working with Anthem, Humana, or United Healthcare, we simplify the process—ensuring your billing is automated, accurate, timely, and compliant every cycle.

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How Paradigm Helps.

Billing

We manage the billing process end-to-end, aligning EVV and billing data for timely payments.

Enrollments

We help you access new payer lines, creating more income opportunities.

Eligibility

We monitor client eligibility and authorizations to ensure continuity of care and payments.

EVV Support

We optimize EVV and AMS configuration to ensure accurate Medicaid billing.

Training

We provide tools and education to help you grow your Medicaid census.
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Medicaid
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Indiana
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Indiana offers a dynamic market with diverse payer options and generous client hour approvals, backed by robust reimbursement rates—fueling a steady cash flow and broadening services for referral partners.

how evv works

Electronic Visit Verification

EVV has become a cornerstone of Medicaid compliance for home care agencies. This federally-mandated system does more than just verify visits—it's your key to faster reimbursements, reduced claim denials, and seamless MCE partnerships. Understanding Indiana's unique EVV requirements is crucial for maintaining compliance while maximizing your agency's revenue potential.

EVV Requirements

The hybrid model in IN allows agencies can choose between Sandata or their preferred EVV software.

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EVV Aggregator

Sandata is Indiana’s official EVV aggregator. Providers using different EVV systems must ensure compatibility with Sandata.

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Billing Process

Billing in Indiana requires separate processing from EVV data. Providers must submit claims either through a clearinghouse or individually to the Indiana Health Coverage Programs (IHCP) portal.

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Rates

How much does Medicaid pay for home care per hour in Indiana?

Indiana stands out as one of the top-paying states for Home Care Medicaid, offering attractive rates such as $34.36 per hour for Attendant Care and $36.92 per hour for Respite services.

It's crucial to note that as Indiana transitions to a pure Managed Care Entity (MCE) model in July 2024, these MCEs may negotiate different rates with agencies. Therefore, it's vital for agencies to meticulously review every payer contract to maintaining financial stability and optimal reimbursement rates.

Payers

Until July 2024, home care agencies in Indiana had the flexibility to receive referrals and payments from the Indiana Health Coverage Programs (IHCP) as well as a variety of Managed Care Entities (MCEs). However, starting in July 2024, the system transitioned, with MCEs becoming the exclusive entities for managing payments and referrals. These include:

Anthem
Humana
United

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