CoreMMIS and the new Provider Healthcare Portal coming
The Indiana Health Coverage Programs (IHCP) is developing a new
information processing system, called CoreMMIS, which will
replace IndianaAIM. Along with CoreMMIS, a new
provider interface called the Provider Healthcare Portal will
replace Web interChange. Notice of the new system's implementation
date - as well as information about the transition and conversion
activities directly affecting providers - will be provided in
advance. The IHCP has established an Indiana
CoreMMIS web page as a reference point for posting
information. Also look for special CoreMMIS bulletins that
will communicate system details and transition plans.
News and Announcements
- Indiana EHR MAPIR upgraded, new user guides available
Indiana Medicaid's Electronic Health Records (EHR) Medical Assistance Provider Incentive Repository (MAPIR) has been upgraded and is now accepting Program Year 2015 Meaningful Use (MU) attestations for eligible professionals (EPs). In addition, new EHR user guides are now available.
- IHCP continues to process delayed claims
As announced in the Indiana Health Coverage Programs (IHCP) Banner Page BR201626, published June 28, 2016, a claims-processing error was identified that affected claims submitted for payment the week of June 20, 2016. The processing system has been corrected; however, not all delayed claims were processed during the expected time frame. Claims submitted June 20, 2016, through June 28, 2016, continue to be processed.
- HCBS waiver claims sent to third-party insurers
A number of paid HCBS claims have been sent to third-party insurers for waiver members who carry private insurance. This action was taken in accordance with federal regulations, which require Medicaid to bill potentially liable third-party insurers to ensure that Medicaid is the payer of last resort. Because these claims were already paid by Medicaid, there should be no action required of waiver providers or members.
- Pharmacies overdue for revalidation are at risk of disenrollment
Indiana Health Coverage Programs (IHCP) records indicate that several pharmacies overdue for revalidation have not yet submitted the necessary revalidation paperwork to the IHCP. Failure to revalidate will result in these pharmacies being disenrolled from the IHCP as of July 31, 2016. See the full article for more information.
- Provider Audit Workgroup to hold public hearings in July
The Provider Audit Workgroup, established by Senate Enrolled Act 364 to "discuss the policies and procedures used in the performance of Medicaid provider audits and possible improvements to the audit process," will hold three public hearings in July to solicit input from interested parties on this topic. See full article for more details.
- 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.
- 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.