26 - Transportation

Initiating Your Enrollment Transaction

  1. See the IHCP Provider Enrollment Type and Specialty Matrix on this website for a list of the documentation you must submit to be enrolled or revalidated as an IHCP provider. Possible specialties under this provider type are:
    • 260 - Ambulance
    • 261 - Air Ambulance
    • 262 - Bus
    • 263 - Taxi
    • 264 - Common Carrier (Ambulatory)
    • 265 - Common Carrier (Non-Ambulatory)
    • 266 - Family Member
  2. The IHCP Transportation Provider Enrollment and Profile Maintenance Packet is the appropriate IHCP provider packet for you to complete for enrollment-related transactions. Detailed instructions are included in the packet. See the Provider Enrollment provider reference module for more information.
    • To enroll, add a service location, report a change of ownership, or revalidate a current IHCP enrollment, you must complete and submit the entire packet.
    • To update an existing Provider Profile, use Web interChange for online updates, submit the appropriate Provider Profile maintenance form, or complete the relevant sections, and submit the IHCP provider enrollment packet, following the instructions provided. See Update Your Provider Profile on this website.
  3. See the IHCP Provider Enrollment Risk Category and Application Fee Matrix on this website to determine your risk level and whether you are required to pay an application fee. The enrollment or revalidation screening process is determined by the risk level that applies to your provider type. At its discretion, the State may assign a provider a higher risk level that supersedes the risk level assigned by the Centers for Medicare & Medicaid Services (CMS) and noted on the matrix.
    • Generally, provider specialties 260 - Ambulance and 261 - Air Ambulance enrollments or revalidations are considered "moderate" risk and are subject to additional screening measures, including pre-enrollment site visits.
    • Generally, at enrollment, provider specialties 262 - Bus, 263 - Taxi, 264 - Common Carrier (Ambulatory), and 265 - Common Carrier (Non-Ambulatory) are considered "high" risk and at revalidation are considered "moderate" risk. Both risk categories are subject to additional screening measures, including pre-enrollment site visits. High-risk provider types are also subject to fingerprinting and criminal background-check requirements.

    Individuals with at least 5% ownership or controlling interest in the enrolling entity must be fingerprinted before submitting the enrollment application and the confirmation number must be entered in the IHCP Provider Screening Addendum included in the packet. See Provider Enrollment Risk Levels and Screening for instructions for fingerprinting. (Note: High-risk providers enrolling or revalidating on or after August 1, 2015 are subject to the fingerprint-based background check. The requirement will be applied retroactively and affected providers already enrolled will be notified of the steps to take and the time frame for compliance.)

    • Generally, provider specialty 266 - Family Member enrollment or revalidation is considered "limited" risk and is not subject to additional screening measures.
    • A transportation enrollment, revalidation, or change of ownership for all specialties except 266 - Family Member requires the payment of an application fee for each service location. Submit confirmation of your electronic payment of the fee to the IHCP or document that you have paid the fee to Medicare or another state Medicaid program on the IHCP Provider Application Fee Addendum included in the IHCP provider packet.
  4. State law requires transportation providers with specialties of common carrier (for-profit ambulatory or non-ambulatory) and taxi to purchase a surety bond to be eligible to enroll. This applies to providers that are newly enrolling, reporting a change of ownership, or reporting a purchase or transfer of assets. A surety bond that meets state requirements can be obtained by contacting a licensed insurance broker and providing the broker with a copy of the Indiana Medicaid Surety Bond Requirements.
  5. The IHCP provider packet is an interactive PDF file, allowing you to type information into the fields electronically, save the completed file to your computer, and print the file for mailing.
  6. Before mailing, make a copy of the completed IHCP provider packet and required documentation for your records.
  7. Mail the packet and other required documentation to Hewlett Packard Enterprise (HPE) at the following address:
    Provider Enrollment Unit
    P.O. Box 7263
    Indianapolis, IN 46207-7263
  8. After you are enrolled as an IHCP provider, if you are interested in enrolling as a provider with the IHCP's managed care program, you must apply directly to one or more of the managed care entities (MCEs). Please see the Managed Care page for information about the programs and the MCEs with which the State contracts for each. Links to the MCE enrollment forms follow:

Processing Your Enrollment Transaction

Please allow at least 20 business days for mailing and processing before checking the status of your submission. After your transaction is processed, the Provider Enrollment Unit will notify you of the results.

  • If the packet needs correcting or is missing required documentation, the Provider Enrollment Unit will contact you by telephone, email, fax, or mail. This contact is intended to communicate what needs to be corrected, completed, and submitted before the IHCP can process your enrollment transaction. If an application is rejected for missing or incomplete information, the entire packet will be returned to you with a letter indicating what needs to be corrected or attached. You MUST return the entire packet, as well as a copy of the provider letter, when submitting the correction or missing information.
  • If the packet is complete, the Provider Enrollment Unit will process your transaction and conduct the appropriate screening associated with your assigned risk level.
  • If the IHCP confirms your enrollment or revalidation, you will receive a verification letter from the Provider Enrollment Unit.
  • If the IHCP denies enrollment or revalidation, you will receive a notification letter explaining the denial reason. If you believe your enrollment or revalidation was denied in error, you may appeal. See the Provider Enrollment provider reference module for information about the appeal process.