CoreMMIS and the new Provider Healthcare Portal coming
At the end of 2015, the Indiana Health Coverage Programs (IHCPs)
information processing system, IndianaAIM, will be
replaced with a new system called CoreMMIS, which stands
for Core Medicaid Management Information System. Along with
CoreMMIS, a new provider interface called the Provider
Healthcare Portal will replace Web interChange. The IHCP has
established an Indiana CoreMMIS web page as
a reference point for posting information about the new system and
the provider portal. Special CoreMMIS bulletins will be
published and posted to this web page to communicate important
system details and transition plans.
News and Announcements
- IHCP reminds all providers about default ICD indicator on Web interChange
Providers must use the appropriate ICD Indicator and the appropriate ICD diagnosis codes when submitting claims via Web interChange. The ICD-9 indicator and ICD-9 diagnosis codes must be used for DOS before October 1, 2015. The ICD-10 indicator and the ICD-10 diagnosis codes must be used for DOS on or after October 1, 2015.
- IHCP reminds transportation providers about ICD-10 requirements
Transportation providers must use the appropriate ICD Indicator and the appropriate ICD diagnosis codes when submitting claims via Web interChange and via paper. The ICD-9 indicator and ICD-9 diagnosis codes must be used for DOS before October 1, 2015. The ICD-10 indicator and the ICD-10 diagnosis codes must be used for DOS on or after October 1, 2015.
- Web interChange outage impacts PE applications September 5-8, 2015
The IHCP's Web interChange tool was unable to process eligibility transactions and Presumptive Eligibility (PE) applications from Saturday, September 5, 2015, through Tuesday, September 8, 2015. At a qualified provider’s request, the eligibility date for members whose PE applications could not be successfully transmitted during that time frame will be backdated to reflect the date the initial processing attempt was made. Requests to correct effective dates must be received by October 2, 2015.
- Reserve your guest room for the IHCP 2015 Annual Provider Seminar by September 12
The IHCP 2015 Annual Provider Seminar, scheduled for October 13-15, 2015, at the Marriott Indianapolis East Hotel in Indianapolis, is fast approaching. Guest room reservations made on or before September 12, 2015, are available at a special rate of $122 plus tax per night – call (317) 352-1231 or 1-800-991-3346 to make your reservation now. When making reservations, indicate you are attending the “Medicaid Seminar” to secure the special rate.
- Pharmacy Benefit Manager, Catamaran, joins with OptumRx
On July 23, 2015, the Indiana Health Coverage Program’s (IHCP’s) fee-for-service (FFS) Pharmacy Benefit Manager (PBM), Catamaran, combined with Optum’s pharmacy care services business, OptumRx. The combination of Catamaran and OptumRx will operate as OptumRx. Providers will begin to see communications and related PBM material referring to OptumRx as the IHCP FFS Pharmacy Benefit Manager.
- Nursing facility rates to be published by October 1, 2015
Contrary to earlier Indiana Health Coverage Programs (IHCP) publications, nursing facility (NF) rates for the quarter beginning July 1, 2015, are still being determined. These rates will be finalized and posted on the Public Notices page of the Myers and Stauffer LC website at in.mslc.com by October 1, 2015.
- Mark your calendar for the IHCP 2015 Annual Provider Seminar
The IHCP 2015 Annual Provider Seminar is scheduled for October 13-15 in Indianapolis. This year's seminar will highlight how the IHCP's new claims processing system, CoreMMIS, will enhance claims submission, provider enrollment, and prior authorization. Watch IHCP publications and this website for more information.
- PE approval letters serve as proof of temporary coverage
The State is aware that some members are presenting for pharmacy and other services before their PE status is visible to providers in the IHCP Eligibility Verification System or in the MCEs’ pharmacy benefits manager (PBM) systems. Please be aware that an original PE approval letter is sufficient to validate temporary coverage even if the member is not listed in the appropriate eligibility system.
- IHCP Makes Changes to Hoosier Healthwise Member Cards
The Indiana Health Coverage Programs (IHCP) is changing how member cards for individuals enrolled in Hoosier Healthwise are issued. Each managed care entity (MCE) will assume responsibility for issuing Hoosier Healthwise member ID cards for newly eligible Hoosier Healthwise members enrolled under their health plan. This change will be implemented in phases and may result in some minor differences in the look of Hoosier Healthwise member cards printed after January 1, 2015.
- Indiana Core MMIS under development
The Indiana Health Coverage Programs (IHCP) is in the design phase of developing an enhanced Medicaid Management Information System (MMIS) to replace its current IndianaAIM system. The new system will include state-of-the-art technology intended to make doing business with the IHCP easier and more efficient.