General Provider Services

If you're an Indiana Medicaid provider - regardless of your provider category or specialty - this section is for you. It links you to information that helps make doing business with the Indiana Health Coverage Programs (IHCP) easier. You'll find details about billing, free provider workshops, forms, the Health Insurance Portability and Accountability Act (HIPAA), how to submit claims electronically, and more. Select a topic from the menu on the left or the list below.

Getting Assistance

If you have questions that aren't answered here or elsewhere on this site, please contact HP Customer Assistance at 1-800-577-1278.

Provider Relations Field Consultants can assist you with enrolling, updating your provider profile, learning to use Web interChange, addressing complex claims concerns, and much more. They also provide one-on-one training in your office and training at the quarterly provider workshops and the annual provider seminar. Contact information for each field consultant is available on the Provider Relations Field Consultants page.

Providing Services

Our goal is to make doing business with Medicaid as efficient as possible. In this section, you'll find links to more detailed information about:

  • Verifying members' eligibility--It takes more than a Hoosier Health Card or even a prior authorization. Find the tools you need at Eligibility Verification.
  • Obtaining prior authorization.
  • Monitoring members' Medicaid use--The Right Choices Program (RCP) monitors members' Medicaid utilization and, when appropriate, implements restrictions for members who use services more extensively than their peers.
  • Finding other Medicaid providers--search by specialty, address, institution, and more at Provider Search.

Billing and Remittance

As a Medicaid provider, what's the best way for you to submit claims to the Indiana Health Coverage Programs (IHCP)? It's a big topic, and an important one. In this section, you'll find links to answers, from provider code sets to fee schedules to a list of explanations of benefits (EOBs). There's also an extensive question-and-answer page about submitting claims. Whether you're new to Medicaid or have been a provider for years, this section is designed to help answer your billing questions.

Electronic Data Interchange (EDI) Solutions

Electronic transactions must be HIPPA compliant. The EDI solutions page provides resources for providers and vendors.

Manuals

IHCP provider manual and specific program manuals and companion guides.

Forms

Forms are available in Adobe Acrobat portable document format (pdf) unless otherwise indicated.  If you do not already have Acrobat, please see the Web Tool Kit.

State Plan

Medicaid is a state administered program and each state sets its own guidelines regarding eligibility and services. The State Plan outlines how Medicaid is implemented in Indiana.