Indiana Medicaid runs four distinct programs with different dental structures; HIP Plus members receive comprehensive dental through DentaQuest while HIP Basic members have no dental benefit except for members aged 19–20 and pregnant members. TransDontics manages your complete Indiana revenue cycle, so you can focus on your patients.
Indiana’s dental market spans Indianapolis to manufacturing hubs like Fort Wayne and Evansville, where Anthem, Delta Dental, and Cigna dominate employer coverage. Underlying every market is a Medicaid structure where confusing HIP Plus and HIP Basic generates more avoidable denials than any CDT coding error.
The HIP Plus vs. HIP Basic Dental Coverage Divide
Multiple MCEs & Multiple Dental Subcontractors
Hoosier Healthwise Dental: Managed Care Program
DSO Expansion in the Indianapolis Metro
TransDontics’s 1,100+ in-house dental billing specialists are supported by RCM automation engineered for Illinois’ dental billing environment. Every process is designed around the actual payer rules, fee schedules, and documentation standards your claims will face.
RCM automation handles HIP tier eligibility verification, claim scrubbing, DentaQuest portal submissions, and status tracking while billing specialists handle appeals, EOB reconciliation, prior auth follow-up, HIP benefit tier disputes, and payer escalations, not left to automation that cannot read clinical context.
Every payment is reconciled against your contracted rate, line by line. When Anthem, Delta Dental, or any commercial payer pays below the agreed fee, we flag it and appeal within 14 days. Underpayments that pass as technically paid are Indiana's most overlooked revenue leakage. We catch them.
We confirm HIP benefit tier, verify prior authorization requirements, and submit PA requests through the DentaQuest Provider Portal before any claim is prepared. When documentation is required without a PA, we attach it at submission, exactly where most vendors leave gaps that produce return-to-provider rejections.
Claims processed within 48 hours of receipt. No setup fee, no monthly minimum, no long-term contract, and no hidden costs. Our fee is a nominal percentage of what we successfully collect from payers on your behalf. We only earn when you get paid; which means our incentives are aligned with your practice's performance from day one.
Expert CDT coding, clean claim submission, and aggressive denial management by specialty-certified billers. 98% first-pass clean claim rate.
Get in-network faster. We handle all payer paperwork, CAQH maintenance, renewals, and compliance tracking so you start seeing insured patients.
Robotic process automation eliminates manual repetitive tasks. Eligibility checks, reminders, and daily reports run without human intervention, 24/7.
Full revenue cycle coverage from patient registration to final payment. We manage all claims, close every gap, and maximize your collections.
Strategic oversight of your practice’s operational and financial performance. We track collections, payer mix, and productivity metrics
Complete front office billing support covering patient billing inquiries, insurance comms, prior auth, and appointment-linked verification.
HIPAA-compliant dental transcription delivered fast and accurately. Clinical notes, procedure documentation, and patient records are transcribed.
We review your last 12 months, find your top 3 revenue leaks, and show you exactly what we fix. Practices often discover recoverable revenue.
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An in-house biller knows your practice, not HIP tier logic, DentaQuest prior auth requirements, Hoosier Healthwise versus HIP MCE routing, or Anthem’s pre-treatment estimates. Turnover resets that knowledge. Ours doesn’t.
Most billing companies submit claims. They won’t catch HIP Basic eligibility denials, manage DentaQuest PAs for HIP Plus members, or pursue commercial underpayments. TransDontics does all of it.
Most billing companies are a service. TransDontics is a system: RPA catching what humans miss at volume, experienced billers catching what automation cannot judge. The result is a first-pass acceptance rate of 98%.
Three steps. No disruption. No risk.
We connect directly to Dentrix, Eaglesoft, or your existing PMS. No migration, no new systems, no disruption.
Three steps. No disruption. No risk.
We review your claims, A/R, and denial patterns at zero cost. Most practices find 5–10% in hidden revenue leakage.
We connect directly to Dentrix, Eaglesoft, or your existing PMS. No migration, no new systems, no disruption.
We don’t publish named case studies because most clients prefer to keep billing performance private. What we can share is what the numbers look like across practices with comparable payer profiles.
Based on aggregated results across dental practices in comparable payer environments.
| Metric | Before TransDontics | After TransDontics |
|---|---|---|
| Average Denial Rate | 8–12% | Under 2.3% |
| First-Pass Clean Claim Rate | 70–80% | 98% |
| A/R Over 90 Days | 30–40% of Total AR | Reduced by 30%+ |
| Average A/R Resolution | 45+ Days | 18–25 Days |
| Claim Turnaround | 3–5 Days | 48 Hours |
| Revenue Growth (120 days) | Baseline | 5–12% Increase |
An Indianapolis practice came to us with an 11% denial rate, 36% of A/R past 90 days, and HIP Basic claims submitted for members without active dental benefits with 2+ hours daily of inconsistent portal follow-up.
Our specialists know HIP Basic excludes dental, Hoosier Healthwise bypasses DentaQuest, MHS uses Envolve Dental, and Anthem and CareSource route HIP dental through DentaQuest. National companies misroute Indiana Medicaid. We don’t.
HHW dental claims route through each MCE’s dental subcontractor, either DentaQuest or Envolve/MCNA; never IHCP fee-for-service. Knowing which MCE pathway applies is where most preventable denials originate.
PathWays dental claims route through each MCE’s dental subcontractor; DentaQuest or Envolve/MCNA; never IHCP fee-for-service. Knowing which MCE pathway applies is where most preventable denials originate.
CareSource administers dental benefits directly for HHW and HIP members via its own portal and SKYGEN; not through a third-party subcontractor. Knowing this independent claim routing is where most preventable denials originate.
Whatever dental insurance your practice accepts, we ensure you get paid. TransDontics’ billing experts navigate the complexities of every major dental insurance network to maximize your revenue.
TransDontics works Indiana claims daily, knowing Indianapolis’s HIP Plus volume, Anthem’s statewide dominance, Fort Wayne’s separate Cigna and Delta Dental fee schedules, and South Bend’s unusually high plan turnover.
Every Indiana practice qualifies. If your city isn’t listed, it’s coming. Reach out now and we’ll onboard your practice without delay.
Every state has its own payer rules, Medicaid structure, and billing landmines. TransDontics expertly navigates all of them.
Indiana practices carry HIPAA, the Indiana Dental Practice Act, and IHCP documentation standards under Title 405. IC § 16-39-7-2 requires records retained seven years and X-rays five. TransDontics is independently HIPAA certified and SOC 2 Type II compliant statewide.
All patient data is encrypted end-to-end, satisfying HIPAA Security Rule technical safeguards and Indiana's health record access and confidentiality requirements under Indiana Code Title 16, Article 39. Every data transmission meets the highest applicable standard, not just the minimum.
Only credentialed TransDontics personnel can access your practice data, eliminating the internal access vulnerabilities that turn in-house billing into a compliance liability most Indiana practice owners do not realize they are carrying until it is too late.
Our AICPA SOC 2 Type II certification is independently audited and renewed annually. Everything is documented and third-party verified; providing demonstrable proof of our security posture. Your Indiana practice's liability exposure is measurably reduced from day one of our partnership.
Customized billing solutions based on your specialty
In-house billing looks cheaper on paper. It rarely is. Staffing overhead, turnover, training, and revenue lost to unworked denials and HIP tier errors mean most Indiana practices spend more than they realize and collect less than they should. TransDontics charges a percentage of what you collect.
Average Indiana salary
Benefits + Payroll Taxes
Software + Training
Turnover Cost
Average Denial Rate
First-Pass Clean Claims Rate
Setup Fee
Contract
~$44,000/yr
~$13,000/yr
~$5,000/yr
~$75,000/replacement
8–12%
70–80%
—
—
Included
None
Included
None
Under 2.3%
98%
$0
Cancel Anytime
*Salary benchmarks based on Indiana BLS/Zip Recruiter data. Results vary by practice size and payer mix.
Our Complimentary audit covers denied claims, MCO routing errors, and underpayments, no obligation, no pitch.
Specific, verified outcomes, not generic praise. Every metric sourced from client data.
In the first 60 days, TransDontics recovered $18,400 in claims our team had written off as uncollectable. They caught 47 denied claims we had given up on. The Dentrix integration was seamless as they were billing the same day.
General Dentist · Austin, TX
I was spending 3 hours a day chasing orthodontic claims. TransDontics took over and our denial rate dropped from 22% to under 4% in three months. The multi-visit treatment plan billing alone recovered $31K we had been losing annually.
Orthodontist · Los Angeles, CA
We run 3 oral surgery locations on Eaglesoft. The OMS anesthesia cross-coding was a mess; TransDontics cleaned it up in week one. Collections are up 11% across all three locations.
Oral Surgeon · Dallas, TX
RPA handles HIP tier eligibility verification, claim scrubbing, DentaQuest portal submissions, Hoosier Healthwise fee-for-service routing, and payment posting. Billing specialists handle appeals, EOB reconciliation, prior authorization follow-up, HIP tier benefit disputes, and payer escalations. The combination sustains 98% first-pass rates. Either layer alone doesn’t achieve it.
DentaQuest’s HIP dental timely filing window is one year from the date of service. Hoosier Healthwise claims through MHS Indiana and Envolve Dental carry a 90 day window. Commercial windows vary; Cigna’s are among Indiana’s shortest. TransDontics tracks every claim against its specific deadline and flags approaching windows for priority action.
No setup fee. No monthly minimum.
Cancel anytime.
Response within 24 hours.
HIPAA-compliant from day one.
Pay only a percentage of what we collect for you
