Participating as an OPR Provider

Participating in IHCP as an OPR provider allows Medicaid reimbursement for the covered services and supplies you order, prescribe, or refer for your IHCP-member patients. A simplified application process requires minimal information and time and makes participation easy. Before enrolling, please note the following:

  • If you are already enrolled as another type of provider in the IHCP you do not need to enroll as an OPR provider.
  • OPR providers cannot submit claims to the IHCP for payment for services rendered. If you wish to be able to submit claims, enrollment as another IHCP provider type is required. To enroll as a billing, group, or rendering provider, refer to the Complete an IHCP Provider Packet page.
  • You must have a National Provider Identifier (NPI).
    • The National Provider Identifier (NPI) is the standard, unique health identifier for health care providers and is assigned by the National Plan and Provider Enumeration System (NPPES).
    • Applying for the NPI is a process separate from IHCP enrollment.
    • To obtain an NPI, apply online at NPPES.cms.hhs.gov.
    • For more information about NPI enumeration, visit cms.gov/NationalProvIdentStand.

Enrolling as an OPR Provider

  1. Complete the IHCP Ordering, Prescribing, Referring Provider Enrollment and Profile Maintenance Packet. Detailed instructions are included in the packet.
    • The IHCP Provider Packet is an interactive PDF file, allowing you to type information into the fields from your computer, save the completed file to your computer, and print the file for mailing.
    • OPR providers are not required to pay an application fee.
  2. Submit the packet using the mailing instructions below.

Updating Your OPR Provider Profile

The information that identifies and describes a specific provider is called a Provider Profile. When your information changes (for example when your license information, contact information, name or address, changes) you are required to submit a profile update to the IHCP within 10 business days.

  1. Complete the IHCP Ordering, Prescribing, Referring Provider Enrollment and Profile Maintenance Packet. Detailed instructions are included in the packet. Complete only the following:
    • Fields 1 through 3 in Section II - Provider Information
    • Any other fields with information that needs to be updated
    • Section VI - Provider Signature/Attestation
  2. Submit the packet using the mailing instructions below.

Recertifying your OPR Provider Enrollment

OPR providers must maintain an active license to remain enrolled in the IHCP. Providers are not required to submit documentation to recertify their enrollment; the IHCP verifies licensing information periodically.

Disenrolling as an OPR Provider

  1. OPR providers may voluntarily disenroll from the IHCP at any time. Complete the IHCP Ordering, Prescribing, Referring Provider Enrollment and Profile Maintenance Packet. Detailed instructions are included in the packet. Complete only the following:
    • Fields 1 through 3 and 14 in Section II - Provider Information
    • Section VI - Provider Signature/Attestation
  2. Submit the packet using the mailing instructions below.

After disenrolling as an OPR provider, you may enroll as another provider type by submitting the appropriate enrollment application packet. For more information about enrolling as another provider type, see the Complete an IHCP Provider Packet page.

Mailing and Processing OPR Provider Transactions

  1. Before mailing, make a copy of the completed provider packet.
  2. Place the packet in an envelope.
  3. Mail the packet to the following address:
    HP Provider Enrollment
    P.O. Box 7263
    Indianapolis, IN 46207-7263

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

  • If the packet is incomplete you will be contacted by the HP Provider Enrollment Unit in an attempt to complete the packet.  If the incomplete packet is not corrected, your application cannot be processed.
  • If the packet is complete, your transaction will be processed.
  • If the IHCP confirms your enrollment, you will receive a verification letter from the HP Provider Enrollment Unit.
  • If the IHCP denies enrollment, you will receive a notification letter explaining the denial reason. If you believe your enrollment was denied in error, you may appeal. See Chapter 4 of the IHCP Provider Manual for information about the appeal process.