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.

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:

  • 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 systems.
  • 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 Data Interchange (EDI) Solutions

Electronic transactions must be HIPAA-compliant. The EDI Solutions pages provide resources for providers and vendors.

Billing and Remittance

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 Materials page.

ProviDER guidance and tools

  • The Provider Education web pages describe training opportunities available to IHCP providers as well as information regarding registration and presentation documents.
  • 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 Toolkit.
  • 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.

Getting Assistance

If you have questions that aren't answered here or elsewhere on this site, please contact Customer Assistance at 1-800-457-4584.

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.