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A multi-provider family medicine practice in Indiana was collecting revenue every month, but nobody on the leadership team could say with confidence how much was being left behind. This is the story of how MBC changed that.
Client Snapshot
- Specialty: Multi-Provider Family Medicine
- Location: Indiana
- EHR Platform: eClinicalWorks (ECW)
- Engagement Period: Q1 2026 (January–March)
- Payer Mix: 15+ payers, including Anthem BCBS, Tricare, Medicare, and Medicaid managed care plans
The Challenge
Family medicine spans the widest service range in outpatient care, preventive visits, chronic disease management, acute care, and behavioral health, billed against a payer mix that had grown past fifteen distinct plans. Anthem BCBS alone represented over a thousand claims a quarter, demanding precise modifier accuracy and dedicated appeal follow-up, while Indiana’s Medicaid managed care plans, including CareSource and MHS HIP, each carried their own timely filing windows and portal-specific rules.
The practice wasn’t struggling in an obvious way. Claims went out, payments came in. But without payer-specific workflows or real-time denial visibility, that volume was quietly producing AR leakage that never surfaces until someone stacks the aging buckets side by side.
The MBC Solution
MBC built a dedicated billing team around the practice’s existing eClinicalWorks environment, with no EHR migration or disruption to how providers documented care. Three changes drove the turnaround: workflows segmented by payer lane, so Anthem BCBS, Tricare, Medicaid managed care, and Medicare each ran under plan-specific appeal language and modifier protocols instead of one generic process; every denial root-caused as it happened, with all 225 ERA denials categorized by cause, modifier error, eligibility mismatch, authorization gap, or timely filing, and routed to resolution within 48 hours; and monthly dashboards giving leadership AR aging by payer, collection velocity, and patient balance segmentation in place of a delayed statement.
The Results
Across the quarter, MBC processed 4,473 claims against $1,436,152 billed, collecting $401,860 total, $321,718 from insurance and $80,142 from patient payments. The ERA denial rate held at 5.0%, well under the 8% to 12% range typical for a comparable multi-payer practice, with all 225 denials actively worked rather than written off. Insurance AR aging told its own story: 67.4% sat in the 0–30 day bucket, meaning most billed charges were in active adjudication rather than follow-up limbo, against an industry-healthy benchmark of 50% to 60%. Claim volume grew steadily, from 1,418 claims in January to 1,591 in March, showing clean-claim protocols scaling with growth instead of breaking under it.
In Their Own Words
“What stood out was the level of detail on every claim. We could see exactly which payers were holding money, which appeals were in flight, and what patient balances looked like by aging bucket. That kind of transparency changes how you run a practice financially.”
Practice Administrator, Multi-Provider Family Medicine Practice, Indiana
Why This Matters for Other Indiana Practices
Indiana’s family medicine practices share a common payer environment: Anthem BCBS as the dominant commercial plan, Medicaid managed care split across CareSource, MHS HIP, and Ambetter, and Tricare volume near military-adjacent communities. Treating those plans as one generic process is why many growing Indiana practices see denials climb as volume grows. This engagement shows what changes when each payer lane is run individually.
About MBC’s Family Practice Billing Services
MBC has supported Family Practice Billing Services for 25+ years, backed by 98% client retention and a system-agnostic model that works inside a practice’s existing EHR. Every client works with a dedicated account manager, supported by Revenue Cycle Management, denial management, credentialing, and old AR recovery. Review the full data behind this engagement in the Family Practice Billing Services case study and How Did MBC Recover $401,860 for This Family Practice? For more, visit MBC’s Indiana medical billing services page.
Request Your Free Revenue Diagnostic to see where your Indiana family practice’s AR aging and denial patterns stand against these results.
Frequently Asked Questions
Indiana practices bill against a mix dominated by Anthem BCBS commercially, alongside Medicaid managed care split across CareSource, MHS HIP, and Ambetter, each with its own timely filing windows and appeal pathways a generic workflow won’t account for.
Industry average ERA denial rates for multi-payer practices run 8% to 12%, so a rate at or below 5%, as achieved here, typically reflects payer-specific modifier accuracy and active appeal management rather than reactive follow-up.
Plans including CareSource, MHS HIP, and Ambetter each carry distinct portal submission requirements and timely filing windows, often 90 to 180 days, that differ from fee-for-service Medicaid and require plan-specific tracking to avoid write-offs.
Most Indiana practices see measurable AR improvement within 60 to 90 days, with the first 30 focused on credentialing verification and workflow setup, denial rates improving by day 60, and AR and NCR gains by day 90.
Yes, MBC’s model is fully system-agnostic; this engagement ran entirely inside the practice’s existing eClinicalWorks environment with no migration or disruption to documentation habits.
How This Indiana Family Practice Recovered $401,860 in One Quarter
Phone: 888-357-3226Fax: 888-316-4566
Email: sales@medicalbillersandcoders.com
Catering to more than 40 specialties, Medical Billers and Coders (MBC) is proficient in handling services that range from revenue cycle management to ICD-10 testing solutions. The main goal of our organization is to assist physicians looking for billers and coders, at the same time help billing specialists looking for jobs, reach the right place.
