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.
If you have questions that aren't answered here or elsewhere on
this site, please contact HP Customer Assistance at
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.
Our goal is to make doing business with Medicaid as efficient as
possible. In this section, you'll find links to more detailed
- Verifying members' eligibility--It takes more than a Hoosier
Health Card or even a prior authorization. Find the tools you need
- 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
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 Chapter 8 of the
IHCP Provider Manual.
Electronic transactions must be HIPAA-compliant. The EDI
Solutions page provides resources for providers and
The Manuals page contains links to the
IHCP Provider Manual, manuals for specific programs, and
Forms on the Forms page 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.
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.