Indiana ihcp provider manual

Nl201012 december provider newsletter indiana medicaid. The pmp agrees to adhere to universally accepted standards or periodicity schedules, of preventive care for pregnant women, infants, children, adolescents and adults. A list of the updated drg relative weights is provided in table 1. Indiana medicaid program commonly referred to as indiana health coverage. Indian health care provider ihcp protocol formerly. May 19, 2015 policies and procedures as of february 1, 2015 version. The requirements for state burial assistance under the medicaid program are also included. Provider healthcare portal registration overview replacing web. The publications on contain the most uptodate information about the ihcp. To enroll, either visit and complete the enrollment forms, or contact the provider enrollment department at the address below.

Emergency for coronavirus disease 2019 outbreak, indiana health coverage programs ihcp enrolled providers may use the following billing guidance for providing services through telemedicine. Plaintiff state of indiana brings this action on behalf of itself and the office of medicaid policy and planning, a division of the indiana family and social services administration, which administers the indiana health coverage program ihcp or indiana medicaid. Sep 24, 2020 provider manual for hoosier healthwise and hip. In accordance with indiana administrative code 405 iac 5172, the ihcp requires prior authorization pa for all nonemergency inpatient hospital admissions, with the following exceptions. For those who have multiple indiana health coverage programs ihcp legacy provider identifiers lpis with the same npi, anthem adheres to the ihcp requirement to establish a. Mdwise care select program addendum to the indiana health. Providers are required to add their email address to the dmha system of care email database. Hoosier healthwise is a health plan for children, pregnant women and lowincome families. The dmha distributes notifications regarding policy and program updateschanges on the indiana soc website and through the websites email database. Indiana covid19 resources upper midwest telehealth. Indiana health coverage programs da home and communitybased services waivers 402 w.

Ihcp provider manual indiana medicaid ihcp providers. Mhs provider claims issue resolution webinar pdf reject reason codes and descriptions pdf, updated january 2017. After information is uploaded by ihcp, the provider will submit the provider. The meetings will cover important updates and discussions with managed care entities mces. Ihcp provider enrollment requirements are based on the type and specialty of the. Thank you for your interest in the indiana health coverage programs ihcp. November, 2014 policies and procedures as of june 1, 2014 version.

Box 7263 indianapolis, in 462077263 dear prospective provider. Mhs follows ihcp claims billing and payment guidelines as outlined in chapter 8 of the ihcp provider manual for all. Since 1994 mdwise has provided access to compassionate, highquality, coordinated health care and education to medicaid members in communities throughout indiana. Caresource values our relationships with our providers, and we are actively working to make it easier for you to deliver quality care to our members. Providers must enroll in the ihcp and obtain a separate provider id to bill transportation services. Indiana laws, rules and policy affecting medicaid reimbursement for. Enroll, disenroll, and update primary medical providers. For psychiatric services, managed care members can self refer to any indiana health coverage programs ihcp enrolled provider licensed to provide psychiatric services within their scope of practice. Medicaid covered iep health related services provider qualifications summary appendix c. Indiana health coverage programs bt201609 february 25, 2016 page 1 of 1 ihcp replaces provider manuals with new ihcp provider reference modules the indiana health coverage programs ihcp has given the ihcp provider manual and the supplemental provider manuals a major facelift. Anthem provides health care professionals with supporting resources to help your relationship with us run as smoothly as possible. Public notice was provided in the september 1, 2003, indiana register. For more information, please refer to the ihcp provider manual, chapter 4.

Home and community based services waiver provider manual. For more information on this topic, please refer to the ihcp provider manual. For updates to information in this module, see ihcp banner pages and bulletins, available at in. Hip is a health plan for uninsured adults ages 1964. Providers must act in such a manner that ensures members receive their member rights and are held to their responsibilities refer to chapter 14.

Mhs will then enroll the practitioner as a noncontracted provider based on the information submitted on the claim unless the practitioner is not enrolled with ihcp at all. The ihcp provider manual and all supplemental provider manuals have been replaced with ihcp provider reference modules. Providers are to submit all accurate provider updates to ihcp at, or contact hp at 18777075750. Division of mental health and addiction 1915i child. All amendments to the ihcp provider manual, the division of aging. The indiana fssa is the umbrella agency responsible for administering indianas public assistance programs. Ihcp bulletin indiana health coverage programs bt201609 february 25, 2016 page 1 of 1 ihcp replaces provider manuals with new ihcp provider reference modules the indiana health coverage programs ihcp has given the ihcp provider manual and the supplemental provider manuals a major facelift. A care management program for people who need help using their health care benefits. Ihcp temporarily removes prior authorization for certain. Ihcp firstquarter provider workshops provider workshops offered through the indiana health coverage programs ihcp will be held throughout the state beginning in march 2016. Indiana health coverage programs provider bulletin bt200420 september 16, 2004 to. The state of indiana s family and social services administrations fssa department administers these state and federal benefit plans through the indiana health coverage programs ihcp.

Download provider manuals for professionals, facilities, and others for more on our programs and policies. In indiana, the federally mandated epsdt program is referred to as the healthwatchepsdt program. Medicaid rehabilitation option mro provider manual library reference number. Provider specific per diem rates for providers classified as provider specialty 0 medicaid longterm acute care ltac hospital, remain unchanged. The indiana health coverage program policy manual is an integrated eligibility manual that contains information about health coverage under medicaid, hoosier healthwise, hoosier care connect, and the healthy indiana plan.

In order to ensure payment, providers must first be registered with ihcp. Caresource has provided medicaid and other managed health care services since 1989. The indiana health coverage programs ihcp medical policy manual contains information about indiana medicaid policies. For further information and guidance related to the code tables, or for diagnosis, procedure, and billing codes other than those appearing in these tables, see the medical policy manual and the ihcp provider reference modules, available from the provider reference materials page of this site. Attachment h indian health care provider ihcp protocol formerly known as the tribal protocol i. To abide by the indiana health coverage programs provider manua. Ihcp replaces provider manuals with new ihcp provider. Jun 11, 2020 in accordance with indiana administrative code 405 iac 5172, the ihcp requires prior authorization pa for all nonemergency inpatient hospital admissions, with the following exceptions. The medical home the primary medical provider pmp serves as the medical home for the member. Indiana health coverage programs provider manual, bulletins, and banner pages, in an amount no greater than provider s usual and customary charge to the general public for the same service. Mce contact information is included in the ihcp quick reference guide, available at in. To be responsible and accountable for the completion, accuracy, and validity of all claims filed under the provider number issued, including claims. Adherence to universally accepted standards of care.

Depending on services or claim components, claim may need to be manually. Division of mental health and addiction 1915i child mental. Provider enrollment and credentialing during the covid19 emergency. The ihcp provider manual is a comprehensive resource, but changes appear first in bulletins, banner pages, and newsletters. Indian health care provider ihcp protocol formerly known. Policy changes that have occurred since the effective date noted are announced in ihcp provider bulletins and banner pages. The provider enrollment module includes detailed information about ihcp enrollment and certification. The taxonomy code submitted on claims must match a taxonomy code listed in the ihcp provider profile. Indiana medicaid and medicare telehealth reimbursement for. Indiana health coverage programs changes in drgloc inpatient and outpatient reimbursement bt200420 september 16, 2004. Provider manuals will be archived and remain available for a limited time for historical reference. Caresource provider manual dear caresource provider, thank you for your participation. Claims submitted for services rendered to noneligible members will not be eligible for payment.

Healthwatchearly and periodic screening, diagnosis, and. The ihcp provider application packet is divided into the following. Restatement of national policy in section 3 of the indian health care improvement act codified at 25 u. Ihcp 1 billing provider application and maintenance form. The indiana health coverage programs ihcp, the division of indiana health and human services administration that oversees indiana s medicaid plans, is seeking presentation topic suggestions for its 2020 provider seminar. Providers should insert this new list into the indiana health coverage programs provider manual. Indiana health coverage programs updated and revised desilte and rebating manufacturers list. Ihcp provider enrollment requirements are based on the type and specialty of the prospective provider and on rules established under code of federal regulations 42 cfr 455, indiana code ic 1215, and title 405 office of the secretary of family and social services. View the most recent published manual at the link below. Providers should make certain their provider enrollment profile with ihcp contains the appropriate primary taxonomy code and any additional taxonomy codes that represent the provider s specialty. Introduction overview this supplemental indiana health coverage programs ihcp provider manual provides instructions.

Mdwise is an indiana licensed nonprofit health maintenance organization offering health care benefits to 300,000 medicaid members. Indiana health coverage programs provider ihcp manual, as amended by provider bulletins. If a claim rejects b2 prior to may 15, 2020, please resubmit after the 15th. Ihcp billing provider application and maintenance form, overview eds provider enrollment unit version 2. Ihcp temporarily removes prior authorization for certain dme.

Cms 1500 quick tips pdf indiana medicaid bulletins and faqs. Enroll as an ihcp provider, check member eligibility, submit and adjust claims, view payments, update provider. All amendments to the ihcp provider manual, hcbs waiver provider manual, all applicable indiana administrative codes iacs, rules, and regulations are binding upon receipt or publication. Through the indiana health coverage programs ihcp secure and easytouse internet portal, healthcare providers can. This document provides information about indiana health coverage programs ihcp claim completion and processing, including the following topics. Materials order form provider manuals and quick reference guides ambetter from mhs claimsbilling indiana medicaid bulletins and faqs medicaid. Indian health care provider ihcp protocol formerly known as the tribal protocol i. Indiana health coverage programs provider manual chapter 2 revision history library reference number. Wagoner is the owner and registered agent of defendants. Ihcp provider workshop dates announced updated claim aid. For more information on this topic, please refer to the ihcp provider manual, chapter 4. Submit all accurate provider updates to indiana health coverage programs ihcp by visiting or by calling the health plan at 18777075750.

Claim completion guidelines provides general information about submitting institutional, professional, and dental claims to the ihcp, including detailed, fieldbyfield instructions for. Ihcp group and clinic provider application and maintenance form, overview eds provider enrollment unit version 2. A referral from the members primary medical provider pmp is not required. Introduction to indiana medicaidcovered iep services tool kit section 4. Sterilization according to 405 iac 5288, ihcp reimburses for sterilizations when the consent form accompanies all claims connected with sterilization that render men or women unable to reproduce. The information in this supplemental provider manual is specifically for early and periodic screening, diagnosis, and treatment epsdt services provided to indiana health coverage programs ihcp members younger than 21 years old. Anthem blue cross and blue shield serving members enrolled in. Ihcp 3 group and clinic provider application and maintenance form. This manual is a resource for working with our indiana providers. If you have questions about this bulletin, please contact eds customer assistance at 317 6553240 in the indianapolis local area or 18005771278. The ihcp provider manual and all supplemental provider manuals have been replaced with. To access these modules, go to the provider reference materials page and open the appropriate module for the topic of interest. Anyone interested in providing feedback should plan to attend an ihcp webinar this wednesday, may 20, at 1 p. The medical home concept assists in establishing a member provider.

Home and communitybased services waiver provider manual, and all applicable indiana. The information in this bulletin may be an update or change to your provider manual. Indiana health coverage programs changes in drg relative weights and new long term acute care hospital level of care reimbursement methodology bt200360 september 16, 2003 eds page 2 of 22 p. Additionally, providers are expected to transport members along the shortest, most efficient route to and from a destination. Anthem provider files must match the states provider information.

Anthem blue cross and blue shield serving members enrolled. Hammond division united states of america and state of. Introduction to help ensure that their medicaidqualified providers of medical services and staff or. Our goals mhs top priority is to promote healthy lifestyles through preventive healthcare. This policy applies to both instate and outofstate providers and all ihcpcovered services, with some. Oct 22, 2020 providers must contact the members managed care entity mce or refer to the mce provider manual.

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