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 following list.
Our goal is to make doing business with Medicaid as efficient as
possible. In this section, you'll find links to more detailed
- Information management - The IHCP utilizes an information
management system called CoreMMIS.
- Online business transactions - Providers interface with
CoreMMIS through an online Provider Healthcare
Portal (Portal). The Portal allows providers to easily conduct
business transactions with the IHCP.
- Verifying members' eligibility--Providers must verify a
member's eligibility before rendering services. Find out about
the IHCP Eligibility Verification
- Authorization for services - Some services require providers to
obtain 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 on the IHCP
Provider Locator tool.
- Requests for policy consideration - The IHCP has a specific Policy Consideration
Process for members, providers, or other interested parties to
submit requests for changes to or questions about IHCP policy.
- Electronic Health Records - The state of Indiana participates
in the federal Electronic Health Records (EHR)
Incentive Program to improve access to health information,
coordination of care, and health outcomes for IHCP members.
Electronic transactions must be HIPAA-compliant. The EDI
Solutions pages provide resources for providers and
As a Medicaid provider, what's the best way for you to submit
claims to the 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). Whether you're new to Medicaid or have been a provider
for years, this section is designed to help answer your
billing questions. For more complete information about billing and
submitting claims, see the Claim
Submission and Processing provider reference
module, as well as other modules available on the Provider Reference
- The Provider Education web
pages describe training opportunities available to IHCP providers
as well as information regarding registration and presentation
- The Provider Reference
Materials page contains links to the IHCP Provider
Reference Modules and the Medical Policy Manual.
- IHCP forms can be accessed on the Forms page. Forms are in Adobe Acrobat portable
document format (PDF), unless otherwise indicated. If you do not
already have Acrobat, please see the Web
- 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.
If you have questions that aren't answered here or elsewhere on
this site, please contact Customer Assistance at
Provider Relations field consultants can assist you with
enrolling, updating your provider profile, learning to use the IHCP
Provider Healthcare Portal, addressing complex claims concerns, and
much more. They also provide one-on-one training in your office and
training at the quartrly provider workshops and the annual provider
seminar. Contact information for each field consultant is available
on the Provider Relations
Field Consultants page.