Indiana

Serving Indiana with purpose

At Vertex Systems, we’re proud to support agencies providing intellectual and developmental disabilities (IDD) and Home & Community-Based Services (HCBS) across Indiana. Indiana’s commitment to community-based support via programs such as the Community Integration and Habilitation (CIH) Waiver gives agencies a tremendous opportunity to serve individuals with IDD in their homes and communities.

Why Vertex Serves Indiana

Community focus

Indiana has structured its waiver programs (such as CIH and the Family Supports Waiver) so that individuals with intellectual/developmental disabilities remain in the community, not institution.

Growing need

With increasing expectations around individualized care, tracking authorizations, utilization, and compliance become key operational challenges.

Regulatory complexity

Indiana’s billing and documentation environment, especially under the Indiana Family and Social Services Administration (FSSA) and the Indiana Health Coverage Programs (IHCP) billing guidelines, requires precision and automation to succeed.

Vertex Systems is uniquely positioned to serve Indiana agencies because our software is already tailored to handle the specific workflows, authorizations, and reporting obligations that come with Indiana’s HCBS/IDD funding landscape. We help you stay mission-driven while staying compliant.

Seamless Billing for IDD Services in Indiana with Vertex

Billing in Indiana – How We Handle the Regulations

Managing billing for IDD and HCBS services in Indiana means navigating a web of authorizations, waiver rules, modifiers, provider types, and electronic visit verification (EVV). Here’s how Vertex supports your agency:

1. Authorization & Service Utilization Tracking

Indiana requires that services under waivers like CIH, Family Supports, and others be authorized with specific codes, units, dates, and providers before services are rendered.
Our system imports authorizations and links them to service delivery, helping you compare actual services delivered versus authorized amounts (units or dollars). This helps you avoid over-billing, under-utilization, or compliance risks.
The system also flags “unmatched” services (e.g., if a service was rendered but no authorization exists) so you spot issues before claims deny. (See how we do this in our Billing Manager and Case Manager modules.)

2. Documentation & Regulation Compliance

Indiana’s HCBS Billing Guidelines specify required documentation: time in/out, signature (or compliant electronic signature), goal referenced in the individual’s Person-Centered Plan, correct use of codes/modifiers, verifying unit counts, checking for waiver liability, etc.
Our workflows are built to ensure you capture the required data at the point of service (or shortly thereafter), and tie the documentation directly to your billing process, reducing claim denials and audit risk.
We also embed logic that prevents billing for services without an authorization or with mismatched units, aligned with Indiana requirements.

3. Claims Submission & Remittance Support

Indiana’s IHCP portal supports fee-for-service (FFS) claims and managed care claims, depending on the waiver/benefit plan.
Our system formats claims correctly for submission (e.g., CMS-1500 or electronic 837), populates required fields (e.g., provider qualifier G2, provider ID, units, modifiers) in compliance with Indiana guidelines.
We support tracking remittance and denials so you can react quickly — keeping a healthy cash flow and avoiding disruption of services to your clients.
Automation of import-authorizations (e.g., import from PDF) and integration of Case Manager and Billing Manager modules reduce manual data input and thereby reduce errors.

4. Built-For Indiana Workflows

Our platform includes pre-configured workflows that reflect Indiana’s waiver models: CIH, H&W, PathWays, FSW, etc. Experience with Indiana’s system means fewer customizations and faster deployment.
Reporting tools allow grouping by consumer traits, service location, provider, and comparing budgeted vs actual utilization, key for agencies under Indiana’s budget- or service-based funding models.

5. Compliance, Audit-Readiness & Peace of Mind

Indiana providers must be prepared for audits regarding authorizations, documentation, EVV, level of care, and billing codes/modifiers. Our system maintains an audit-trail: who entered what, when service was delivered, when billed, any edits.
Real-time dashboards highlight potential issues (e.g., services billed without authorizations, services nearing budget limits, provider utilization out of line) — so you act proactively.
Coupled with Indiana’s regulatory sources (IHCP Billing & Remittance guidance, HCBS Billing Guidelines) your agency’s billing operation becomes a strength rather than a risk.

Your Indiana Partner

If you are serving Indiana’s IDD or HCBS population, you need more than generic software, you need a partner that understands Indiana’s unique funding and billing landscape. Vertex Systems is that partner. We help you focus on delivering quality outcomes, not wrestling with spreadsheets or compliance headaches.

Ready to learn more?

Contact us today for a demo of how Vertex works for Indiana providers. Your billing shouldn’t slow you down, let Vertex empower you.