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CoreMMIS and new Provider Healthcare Portal are live!

The Indiana Health Coverage Programs (IHCP) has implemented its new information processing system, CoreMMIS, as well as the new provider interface called the Provider Healthcare Portal (Portal). Find important information about the new system on the Indiana CoreMMIS and Provider Healthcare Portal web pages, and watch for IHCP bulletins to learn about post-implementation updates.


News and Announcements

  • OPR providers required to revalidate their IHCP enrollment

    06/13/2017 - The Centers for Medicare & Medicaid Services (CMS) recently provided guidance clarifying that ordering, prescribing, and referring (OPR) providers must revalidate their Medicaid enrollments at intervals not to exceed every five years. Accordingly, the Indiana Health Coverage Programs (IHCP) is requiring enrolled OPR providers to revalidate based on their initial enrollment date.

  • IHCP is addressing system issues with batch 270/271 eligibility transactions

    05/22/2017 - With the implementation of CoreMMIS, the Indiana Health Coverage Programs (IHCP) has identified issues with batch 270/271 eligibility transactions. These issues affect only electronic eligibility inquiries for a small percentage of Medicaid members. They do not affect eligibility inquiries performed via the Provider Healthcare Portal or the Interactive Voice Response (IVR) system. The IHCP anticipates resolution the 270/271 batch issues on May 24, 2017.

  • IHCP addresses system problems with MRO, AMHH, BPHC, and CMHW benefit packages

    05/18/2017 - With the implementation of CoreMMIS, the Indiana Health Coverage Programs is aware of various challenges associated with member benefit packages for Medicaid Rehabilitation Option (MRO), Adult Mental Health Habilitation (AMHH), Behavioral and Primary Healthcare Coordination (BPHC), and Child Mental Health Wraparound (CMHW) services. See the full article for information on the current status of the identified issues.

  • Provider Healthcare Portal Update

    05/11/2017 - The Provider Healthcare Portal is functional at this time. Please resume use.

  • IHCP allows providers until September 1, 2017, to update rendering provider linkages

    05/03/2017 - IHCP policy requires rendering providers to be linked to the locations where they render services for a group practice. In CoreMMIS, claims billed for services performed by rendering providers not linked to the specific service location on the claim deny for EOB 1010. The IHCP will temporarily convert EOB 1010 to a “post-and-pay” status through August 31, 2017, allowing providers ample time to link rendering providers to the appropriate group locations.

  • IHCP transitions certain members from Hoosier Healthwise to Traditional Medicaid

    04/27/2017 - Effective May 1, 2017, the IHCP will serve enrolling adult refugees eligible for coverage under the low-income parent/caretaker aid category through Traditional Medicaid rather than through Hoosier Healthwise. As a result, these members will receive services via the fee-for-service delivery system, rather than under a managed care health plan. Providers are reminded to check member eligibility to know which delivery system applies for PA and billing purposes.

  • PA authorization number is case-sensitive in the Provider Healthcare Portal

    04/26/2017 - The Indiana Health Coverage Programs (IHCP) informs providers that the field for the authorization number used to search and review prior authorization (PA) requests in the Provider Healthcare Portal is case-sensitive. Alpha characters in the authorization number must be keyed in UPPER CASE. If the authorization number is keyed incorrectly, providers will receive an “authorization not found” error message.

  • Income limit calculating incorrectly for presumptive eligibility applications

    04/21/2017 - The Indiana Health Coverage Programs (IHCP) has identified that the federal poverty level (FPL) income limit calculation for determining presumptive eligibility is computing incorrectly. As a result some applicants are either being denied eligibility altogether or being approved only for limited coverage under the Family Planning Eligibility Program in error. The IHCP is working on a permanent solution to this issue. Refer to the full article for an interim solution.

Doc box 100CoreMMIS

The new CoreMMIS claims processing system will more accurately and efficiently adjudicate claims. More information

Doc in a BoxProvider Healthcare Portal

Enroll as a provider, submit claims, check member eligibility, update your provider profile, and much more. More information