Recertify Provider Enrollment Licenses and Other Certifications

Recertification of expiring licenses, insurance information (if applicable) and other certifications is necessary for providers to continue to be eligible for enrollment with the Indiana Health Coverage Programs (IHCP). If a provider is required to recertify, a notification is sent to the provider 60 business days before the end date of a provider's eligibility to participate.

Provider types listed on this page are required to file the IHCP Provider Enrollment Recertification of Licenses and Certifications Form to recertify or update expiring licenses, insurance information (if applicable), and certifications. If your provider type is required to recertify or update expiring licenses and you are not listed on this page, IHCP verification of your recertification or license update occurs electronically and you do not need to file this form.

Note: The following instructions do not apply to ordering, prescribing, or referring (OPR) providers. For information on recertifying an OPR enrollment, go to Participating as an OPR Provider.

If you recertify before your eligibility end date, recertification requires only the submission of the IHCP Provider Enrollment Recertification of Licenses and Certifications Form from the Update Your Provider Profile page on this website, along with updates to the expiring license and credential documents.

If you fail to recertify before your eligibility end date, you must reenroll with the IHCP by submitting a new IHCP Provider Enrollment Packet in its entirety.

The following providers are required to submit the recertification form along with documentation to recertify:

  • Provider type 01 - Hospitals that are out of state (OOS) and are eligible for the IHCP must recertify on or before their license expiration date. Providers with open-ended licenses must submit their Joint Commission on Accreditation of Healthcare Organizations (JCAHO) certification that shows their approval period.
  • Provider type 26 - Transportation providers of all specialties must recertify before their license expiration date, based on the requirements listed on the IHCP Provider Enrollment Type and Specialty Matrix. Transportation providers must submit renewed licenses and certificates.
  • Provider type 28 - Out-of-State Laboratory providers with Specialty 281 - Mobile Lab or 283 - Mobile Independent Diagnostic Testing Facility (IDTF) must submit renewed licenses before their license expiration date.
  • Provider type 29 - Out-of-State Radiology providers with Specialty 291 - Mobile X-Ray Clinic must submit renewed licenses and certificates before their license expiration date.

Note: "Recertification" of enrollment credentials is not the same as "revalidation" of enrollment. For more information about revalidation, see the Provider Enrollment Revalidation page on this website.

Basic Steps to Recertify

  1. Use the IHCP Provider Enrollment Type and Specialty Matrix to determine recertification requirements. The licenses or certifications required to recertify are the same as those required to enroll.
  2. Complete the IHCP Provider Enrollment Recertification of Licenses and Certifications Form from the Update Your Provider Profile page of this website.
    • Detailed instructions are included in the form.
    • Be sure to get appropriate signatures and include all supporting documentation required.
  3. The recertification form 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.
  4. Before mailing, make a copy of the form and other documentation for your records.
  5. Mail the form and other required documentation to Hewlett Packard Enterprise at the following address:
    Provider Enrollment Unit
    P.O. Box 7263
    Indianapolis, IN 46207-7263

Processing Your Recertification

Please allow at least 20 business days for mailing and processing before checking the status of your recertification. After the Provider Enrollment Unit processes your recertification form, you will be notified of the results.

  • If the form is incomplete or the required documentation is not included, you will be contacted 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 transaction. If an application is rejected for missing or incomplete information, the entire submission will be returned to you with a letter indicating what needs to be corrected or attached. You will need to make corrections and resubmit the recertification paperwork.
  • If the form is complete, it will be processed and you will receive notification.