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IHCP Provider Enrollment Transactions

• IHCP Provider Enrollment Transactions
• Affordable Care Act (ACA) Requirements
• Complete an IHCP Provider Packet
• Ordering, Prescribing or Referring Providers
• Update Your Provider Profile
• Recertify Provider Enrollment Licenses and Other Certifications
• Qualifying for Increased Physician Reimbursement for Primary Care Services
• Disenroll from the IHCP
• Locations in Need of Providers
• National Provider Identifier (NPI)

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IHCP Provider Enrollment Transactions

In compliance with the Affordable Care Act (ACA) requirements (42 CFR 455), the Indiana Health Coverage Programs (IHCP) has made significant changes to provider enrollment policies and procedures effective January 1, 2012. Provider forms, instructions, and processes have been updated to reflect ACA requirements. Please familiarize yourself with the information on these web pages before proceeding with any enrollment-related transaction. Additional information can be found in Chapter 4 - Provider Enrollment, Eligibility, and Responsibilities of the IHCP Provider Manual.

IHCP Providers - Select the Transaction That Applies

• Enroll as an IHCP Provider for the first time
• Add a service location to an existing IHCP provider
• Report a change of ownership for an existing IHCP provider
• Revalidate enrollment as an IHCP provider
• Update provider profile information of an existing IHCP provider
• Recertify enrollment licenses and other certifications
• Enroll as a provider with a managed care entity under IHCP:
  • MCE Provider Enrollment Form
  • MCE Provider Credentialing Form
• Disenroll from the IHCP

Notes:

1. If you are interested in participating as an IHCP provider only to be able to order, prescribe, or refer covered services and/or medical supplies for your Medicaid-eligible patients, go directly to the Ordering, Prescribing, or Referring Providers page.
2. If you are a physician with a specialty designation of family medicine, general internal medicine, or pediatric medicine, or a subspecialty thereof, you may qualify for the temporary rate increase in Medicaid payments for qualifying primary care services, as authorized under the Affordable Care Act (ACA). Find additional information on how to qualify on the Qualifying for Increased Physician Reimbursement for Primary Care Services page.

Appeals Process

If a provider's enrollment is involuntarily terminated or the IHCP denies a provider's enrollment or revalidation, the provider has the right to appeal the decision. See Chapter 4 of the IHCP Provider Manual for details about the appeals process.

Additional Information

For information about regularly scheduled training sessions on completing provider enrollment paperwork, visit the Provider Education page of this website.

The following links provide useful information you may need after you have enrolled.

• Subscribe to email notifications - The Email Notification System is used to send notices to subscribers on behalf of the IHCP. Notices are sent when new documents, such as bulletins or chapters of the IHCP Provider Manual, are published to the website. You may change your subscription profile or unsubscribe at any time. Email addresses are never sold or used for any purpose other than IHCP business.
• Set up additional users to access Web interChange - Web interChange is a secure website that enables you to submit claims, check member eligibility, update your provider profile, and much more. The person listed on the IHCP Provider Packet will be set up to access Web interChange. See the Web interChange site for information about setting up additional users to access Web interChange.